Muhammad Zafrullah Arifin
Department of Neurosurgery, Faculty of Medicine, Universitas Padjdajaran-Dr. Hasan Sadikin General Hospital

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INCIDENCE OF CAVUM SEPTUM PELLUCIDUM AND CAVUM VERGAE IN DR. HASAN SADIKIN GENERAL HOSPITAL, BANDUNG, INDONESIA Faried, Ahmad; Soeprajogo, Adolf Setiabudi; Melia, Regina; Arifin, Muhammad Zafrullah
International Journal of Integrated Health Sciences Vol 5, No 1 (2017)
Publisher : International Journal of Integrated Health Sciences

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Objective: To describe the cavum septum pellucidum (CSP) and cavum vergae (CV) findings. Methods: Thirteen samples were recruited in the study. The study was conducted at the Department of Neurosurgery, Dr. Hasan Sadikin Hospital, Bandung, Indonesia in the period of 2015?2016. Thirteen samples were recruited for the study. Cavum septum pellucidum and CV spaces are relatively rare. During neurology and neurosurgery examination of patients with head computed tomography (CT) scan and magnetic resonance imaging (MRI), CSP and CV were discovered accidentally. The incidence of these unique spaces reported from many countries, but have never been reported from Indonesia.Results: This is the first-time reported incidental finding of CSP and CV from Indonesia, 13 cases in one-year period. Since the presence of CSP and CV is usually asymptomatic, clinician seem don?t really care to put it in their report.Conclusions: The presence of CSP and CV as a common incidental finding can be more revealed in our country in years to come and hopefully can be more studied in term of anatomical landmark on neurosurgical field.Keywords: Cavum septum pellucidum, cavum vergae, incidental finding DOI: 10.15850/ijihs.v5n1.964
AMYOTROPHIC LATERAL SCLEROSIS: FIRST CASE REPORT IN DEPARTMENT OF NEUROSURGERY, FACULTY OF MEDICINE, UNIVERSITAS PADJADJARAN, BANDUNG Faried, Ahmad; Saputra, Priandana Adya Eka; Dhuha, Alief; Arifin, Muhammad Zafrullah
International Journal of Integrated Health Sciences Vol 7, No 1 (2019)
Publisher : International Journal of Integrated Health Sciences

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Objective: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that is incurable and results in paralysis of the muscles. Electromyography (EMG) is used to diagnosis amyotrophic lateral sclerosis. Although recently there is no cure for ALS, knowledge has increased significantly in the past several years and is helping those who are newly diagnosed.Methods: This study reported for the first time in Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin General Hospital, Bandung a 58-year old man who was presented in the institution with a history of weakness of both lower extremities for four months preceded by weakness of both upper extremities since the previous month. There was no history of any medical illness or any chronic medication. The patient then underwent EMG studies, followed by muscle biopsy.Result: Electromyography and histopathological results confirmed a diagnosis of ALS.Conclusion: This case was so exceptional, since ALS occurrence in Neurosurgery Centre is extremely rare, and the diagnosis can only be established through EMG and histopathological of muscle biopsy studies.Keywords: The fist reported of ALS in Neurosurgery Bandung, electromyography studies 
COMPARISON OF HISTOLOGICAL CHARACTERISTICS OF DRIED AND FRESH AMNION MEMBRANES AND DURA MATER IN NON-HUMAN PRIMATE (MACACA FASCICULARIS) Indah, Astrina Rosaria; Bolly, Hendrikus Masang B.; Faried, Ahmad; Arifin, Muhammad Zafrullah; Achadiyani, Achadiyani; Wirakusumah, Firman Fuad
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (303.785 KB) | DOI: 10.15395/mkb.v51n1.1651

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This study aimed to characterize the histological properties of dry-lyophilized amniotic membrane, fresh amniotic membrane (AM), and duramater membrane in search for a biologically-derived material suitable for meninges surface reconstruction. This descriptive study was conducted at the Unit-3 Laboratory of Animal Test of PT. Bio Farma (Persero), Bandung and Cell Biology Laboratory of the Faculty of Medicine, Universitas Padjadjaran Bandung. This study was conducted from 2018-2019. Fresh Macacafascicularis placenta from healthy donors,classified as specific pathogen-free for TB, SIV, SV40, Polio type 1,2,3, Foamy virus and Herpes B virus, were obtained from selected caesarean sections.The harvested dried and fresh AM and duramater membrane were stained with hematoxylin-eosin and prepared for characterization. Histological examination of dry-lyophilized and fresh AM showed similar results. Histologically, AM is represented by a single layer of metabolically-active cuboidal to columnar epithelium with microvilli firmly attached to a basement membrane and an avascular and relatively sparsely populated stroma. Meninges layers consists of 3 layers: duramater, arachnoid membrane, and piamater. Most of these cells have the same characteristics as fibroblasts, including long organelles and nuclei with various levels of fibril formation. The histological study of amniotic membrane and duramater membrane shows comparable results. The AM is a biologically-derived material suitable for meninges surface reconstruction since its histological structure is somewhat similar to that of the duramater. Its structure is ideal for replacing duramater since it has several characteristics, such as having hygroscopic properties, good biocompatibility, relatively easy to apply, and inexpensive. Key words: Dried and fresh amnion membranes, duramater membranes, non-human primate Karakteristik Histologis Membran Amnion Jenis Kering dan Segar dengan Membran Duramater pada Primata Non-Human Macaca fascicularisPenelitian ini bertujuan mengetahui karakteristik histologis membran amnion kering yang diliofilisasi, membran amnion segar, dan duramater, dalam rangka mencari bahan biologis yang cocok untuk rekonstruksi permukaan meninges. Penelitian deskriptif dilakukan di Laboratorium Hewan Uji PT. Bio Farma dan Laboratorium Biologi Sel FK Universitas Padjadjaran periode 2018-2019. Plasenta Primata non-human Macaca fascicularis segar dari donor sehat, yang bebas dari pathogen spesifik TB, SIV, SV40, Polio tipe 1, 2, 3, virus Foamy dan virus Herpes B, diperoleh dari seksio sesarea. Kemudian, dilakukan pewarnaan dengan hematoxylin-eosin untuk membran amnion kering dan segar, serta membran duramater untuk mengetahui karakterisasi histologisnya. Pemeriksaan histologis membran amnion kering-yang aktif bermetabolisme hingga kolumnar dengan mikrovili; melekat kuat pada membran basal dan stroma yang avaskular dan relatif jarang. Lapisan Meninges terdiri dari 3 lapisan: duramater, arachnoid dan piamater. Sebagian besar sel-sel ini memiliki karakteristik yang sama dengan fibroblas. Studi histologis membran amnion dan membran duramater memiliki struktur yang relatif serupa. Membran amnion adalah material yang secara biologis cocok untuk rekonstruksi permukaan meningen, karena struktur histologinya agak mirip dengan duramater. Oleh karena itu secara struktur, membran amnion ideal untuk menggantikan duramater karena memiliki beberapa karakteristik seperti sifat higroskopis, biokompatibilitas baik, mudah diterapkan, dan murah.Kata kunci: Membran amnion segar dan kering, membran duramater, primate non-human
EVALUATION OF TRAUMATIC BRAIN INJURIES DUE TO ALCOHOL INTOXICATION: STUDY IN CENTRAL HOSPITAL IN WEST JAVA Bolly, Hendrikus Masang Ban; Sutiono, Agung Budi; Faried, Ahmad; Yembise, Trajanus Laurens; Arifin, Muhammad Zafrullah; Wirjomartani, Benny Atmadja
JURNAL WIDYA MEDIKA Vol 6, No 1 (2020): April
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Background: Alcohol intoxication is one of the predisposing factors for the incidence of traumatic brain injury (TBI). At present, there are no hospital-based specific data that provide TBI prevalence rates due to alcohol intoxication, especially in West Java. Objective: This study aims to make descriptive observations about the incidence of TBI due to alcohol intoxication in one of the central referral hospitals in West Java. Method: A retrospective cross-sectional study was carried out involving 10,662 TBI patients recorded in the emergency department database and the Department of Neurosurgery daily case database in the period 2012 to 2018. All data relating to the two items were analyzed. Alcohol intoxication is known from a history of autoanamnesis, alloanamnesis, and the subjective identification of the examiner of alcohol odor on the breath in TBI patients who enter the emergency room. Statistical cross-tabulations were performed to present clinical and demographic phenomena in TBI cases due to alcohol intoxication. Results: The analysis showed that the prevalence of alcohol intoxication in TBI cases was 4.77% (N = 507), all of which were due to motor vehicle accidents. Mean age of 26.44 ± 9.32 years (median 24 and range 12-64). The predominant age in TBI cases due to alcohol intoxication was in the age range of 20-30 years (44.2%), and male sex 92.7%. Most cases occurred in May (12%) and on Saturdays. Based on the consciousness assessment, initial Glasgow Coma Scale in emergency department were 14 (35.9%) and classified as mild TBI (69.2%). Subarachnoid hemorrhage and cerebral contusion are predominantly lesions found on CT scans of patients (2.2%), anterior skull base fractures of 8.1%, and linear fractures (5.1%) are the dominant extracranial lesions. Soft tissue lacerations are found in 16% of all cases. Craniotomy surgery was performed in 3.6% of patients for epidural, intracerebral, and subdural hemorrhage lesion evacuation as well as correction of depressed skull fractures. About 45% were treated for a minimum of three days to observe changes in their consciousness status before discharge. Conclusion: Alcohol consumption before the head injury in motor vehicle accidents has a relationship with various complications. Alcohol intoxication is a complex issue, and more research needs to be done to create comprehensive prevention programs and regulations.
PERBANDINGAN PENGUKURAN STATUS SEDASI RICHMOND AGITATION SEDATION SCALE (RASS) DAN RAMSAY SEDATION SCALE (RSS) PADA PASIEN GAGAL NAFAS TERHADAP LAMA WEANING VENTILATOR DI GICU RSUP Dr.HASAN SADIKIN BANDUNG Deli, Hellena; Arifin, Muhammad Zafrullah; Fatimah, Sari
Jurnal Riset Kesehatan Vol 6, No 1 (2017): MEI 2017
Publisher : Poltekkes Kemenkes Semarang

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Sedation is an important factor to improve patient comfort. Over sedation may lead to a longer ventilator time. To prevent over sedation need an instrument can measure accurately the status of sedation. This study aimed to analyze the differences between Richmond Agitation Sedation Scale (RASS) and the Ramsay Sedation Scale (RSS) in measuring the status of sedation for respiratory failure patient against time weaning ventilator. This study is observational analytic with prospective cohort study. This study was conducted in 13 respiratory failure patient and use mechanical ventilator. Sampling is done by non probability sampling method with consecutive sampling that received sedation therapy in GICU RSUP Dr Hasan Sadikin, Bandung. Samples will be measured with two sedation instrument they are RASS and RSS. Patient will be observed until the patient is successfully weaning ventilator mode CPAP or CPAP PS with PS 5-8 cmH2O and PEEP 5 cmH2O.These results indicate the measurement status with RASS sedation and RSS have a significant impact on weaning ventilator time with a value of p <0.05. Based on analysis results there is a significant difference between the measurement of sedation status by RASS and RSS for respiratory failure patient and weaning ventilator time with p <0.05, and the post hoc analysis shows that there are differences in each measurement sedation with p <0,05.Measurement status with RASS sedation better in reducing the length of ventilator weaning compared to RSS. This study can be used as the basis for further research regarding the relationship status measurement sedation to morbidity, mortality and length of stay in patients receiving sedation therapy.
COMPARISON OF SUPERFICIAL SURGICAL SITE INFECTION IN SIMPLE INTERRUPTED AND HYBRID MATTRESS SUTURE AFTER POSTERIOR APPROACH FOR SPINE SURGERY Risdianto, Ajid; Dahlan, Rully Hanafi; Adam, Achmad; Priguna, Firman; Arifin, Muhammad Zafrullah
International Journal of Integrated Health Sciences Vol 3, No 2 (2015)
Publisher : International Journal of Integrated Health Sciences

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Objective: To compare the incidences of superficial surgical site infection after posterior approach procedures in simple interrupted suture groups compared with hybrid mattress suture group. Methods: A number of 38 patients who underwent posterior approach procedure were randomized into two groups. First group was sutured using simple interrupted suture while the second was using hybrid mattress suture. Bivariate statistical analysis was performed using Chi square test and Mann Whitney test. The superficial surgical site infection incidence was evaluated and recorded for both groups.Results: A superficial surgical site infection was found in 26.3% of the simple interrupted group and no infection was found in the hybrid mattress group. Statistical analysis showed a p value of 0.046.Conclusions: Compared to simple interrupted suture, hybrid mattress suture has less superficial surgical site infection in posterior approach for spine surgery.Keywords: Hybrid mattress suture, simple interrupted suture, superficial surgical site infection, wound healing DOI: 10.15850/ijihs.v3n2.589
ANTERIOR TRANSPETROSAL UNTUK LESI PADA FOSA KRANIALIS MEDIA DAN POSTERIOR: REVIEW LITERATUR DAN DISEKSI KADAVER Arifin, Muhammad Zafrullah; Sutiono, Agung Budi; Faried, Ahmad; Kawase, Takeshi; Wirjomartani, Beny Atmadja; Wiriadisastra, Kahdar
Majalah Kedokteran Bandung Vol 42, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Reseksi selektif pada bagian anterior piramid os petrosus (segitiga Kawase), dengan terlebih dahulu melakukan kraniotomi pada dinding lateral fosa kranialis media, dapat memberikan lapang pandang bedah yang cukup luas dari parasellar, clivus dan cerebellopontine angle (CPA), tanpa mengorbankan struktur organ pendengaran dalam (internal acoustics organ). Keuntungan utama teknik anterior transpetrosal ini adalah dapat langsung mengakses tumor yang melekat pada klivus melalui rongga kecil yang dibuat pada apeks os petrosus. Pengangkatan tumor dengan perdarahan yang minimal dapat dicapai dengan melakukan koagulasi pada arteri tentorium dan akses langsung ke arah anterior kanalis auditorius internus, juga dapat mengurangi cedera pada nervus fasialis dan vestibulokoklearis. Keuntungan lainnya, yaitu, rendahnya risiko komplikasi perdarahan vena, karena teknik ini tidak mengekspos sinus sigmoid ataupun vena Labbe. [MKB. 2010;42(2):86-91].Kata kunci: Anterior transpetrosal, fosa media dan posterior, diseksi kadaverAnterior Transpetrosal for Lession in Middle and Posterior Fossa: Literature Review and Cadaver DissectionResection of the anterior part of pyramid through the middle fossa craniotomy will give us a surgical field of the parasellar, clivus and cerebellopontine angle without sacrificing the auditory structure. The advantage of the anterior transpetrosal approach is the direct access to tumors that attached to the clivus via a keyhole created on the petrosus apex. Bloodless tumor removal can be achieved by detachment of the tentorial artery and direct access of the anterior internal auditory canal also can minimize the injury of the cranial nerve facialis and vestibulocochlearis. Another advantage is the low risk of venous damages since this approach is not exposing the sigmoid sinus and the vein of Labbe. [MKB. 2010;42(2):86-91].Key words: Anterior transpetrosal, middle and posterior fossa, cadaver dissection DOI: http://dx.doi.org/10.15395/mkb.v42n2.219
KADAR PROTEIN S-100 SERUM PENDERITA FRAKTUR OROMAKSILOFASIAL YANG DISERTAI CEDERA KEPALA RINGAN Miguna, Hayana; Arifin, Muhammad Zafrullah
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Penderita fraktur oromaksilofasial sering disertai dengan cedera kepala karena letak dan strukturnya yang berdekatan. Penilaian kemungkinan untuk lesi intrakranial setelah cedera kepala ringan merupakan tantangan utama dalam mendiagnosisnya. Salah satu metode yang dapat digunakan yaitu dengan menggunakan biomarker (petanda biokimia) protein S-100 serum yang merupakan protein neuron-spesifik. Tujuan penelitian adalah untuk menilai peningkatan kadar protein S-100 serum dan melihat perbedaannya berdasarkan lokasi fraktur oromaksilofasial pada cedera kepala ringan. Penelitian ini menggunakan metode studi kasus kontrol yang dilakukan di RS Dr. Hasan Sadikin Bandung pada bulan November 2010?Januari 2011. Sampel berjumlah 76 orang yang terdiri atas 38 penderita dewasa fraktur oromaksilofasial disertai dengan cedera kepala ringan dan 38 orang dewasa sehat sebagai kontrol. Hasil penelitian menunjukkan bahwa pada penderita fraktur oromaksilofasial dengan cedera kepala ringan diperoleh kadar protein S-100 serum rata-rata meningkat sebanyak dua kali lipat, yang secara statistik signifikan dengan t hitung=2,26 atau nilai p=0,0135. Bila kelompok penderita yang satu dibandingkan dengan kelompok penderita lainnya, maka didapatkan hasil yang tidak signifikan secara statistik atau dapat dikatakan mempunyai kadar protein S-100 serum yang sama. Simpulan, pada penderita dewasa fraktur oromaksilofasial disertai cedera kepala ringan terdapat peningkatan kadar protein S-100 serum dan tidak terdapat perbedaan kadar protein S-100 serum berdasarkan lokasi fraktur oromaksilofasial. [MKB. 2012;44(4):233?39].Kata kunci: Cedera kepala ringan, fraktur oromaksilofasial, protein S-100 serumSerum Levels of S-100 Protein in Oromaxillofacial Fracture Patients with Mild Head InjuryOromaxillofacial fracture is often accompanied by head injury due to its adjacent location and structure. Risk estimation for clinically relevant intracranial lesions after minor head injury remains a major diagnostic challenge. One possible method to evaluate the possibility of intracranial lesion is by using biomarkers (biochemical marker) protein S-100. Protein S-100 is a neuron-specific protein. The aim of present study was to assess the elevated levels of S-100 protein serum and to investigate whether there was any difference in the S-100 protein serum concentrations depending on the location of the oromaxillofacial fractures in mild head injury. This study was performed using analytic observational method with case control research design conducted at Dr. Hasan Sadikin General Hospital Bandung between November 2010 and January 2011. There were 76 samples, comprised of 38 adult patients with oromaxillofacial and mild head injury and 38 healthy adults as a control group. The result showed that there was an increase level of S-100 protein serum concentrations in patients having oral and maxillofacial fractures with mild head injury. The concentration increased on average twice as much, which was statistically significant at t test=2.26 with p-value=0.0135. If one group of patients was compared with other patient groups, however, the results were not statistically significant, or it can be stated to have the same level of S-100 protein serum concentrations. In conclusion, oral and maxillofacial fractures in adult patients with mild head injury have elevated levels of S-100 protein serum concentrations and there is no difference in S-100 protein serum concentrations based on the location of oromaxillofacial fractures in mild head injury. [MKB. 2012;44(4):233?39].Key words: Mild head injury, oromaxillofacial fracture, S-100 protein serum DOI: http://dx.doi.org/10.15395/mkb.v44n4.178
CYSTIC MENINGIOMA IN THE INTER-HEMISFERIC SPACE LOCATION Arifin, Muhammad Zafrullah; Tjahjono, Firman Priguna; Sutiono, Agung Budi; Faried, Ahmad
International Journal of Integrated Health Sciences Vol 4, No 1 (2016)
Publisher : International Journal of Integrated Health Sciences

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Objective: The presentation of cystic meningioma in the inter-hemispheric near the falx cerebri is uncommon. It is difficult to differentiate it from intra-axial tumors, such as gliomas. Therefore, it is likely that it is misdiagnosed as other types of brain tumors.Methods: In this study, we reported a cystic meningioma case in the inter-hemispheric location, showing an intramural nodule on magnetic resonance imaging scans.Results: Patient underwent surgical treatment and pathological section confirmation revealing meningioma. The patient was a middle-age woman and had been misdiagnosed as suffering from glioma followed by slight hemipharesis on the right extremities.Conclusions: Although this is a rare case, it will be good if we always consider cystic meningioma in inter-hemispheric space when diagnosing this type of cystic lesion if the magnetic resonance imaging (MRI) shows a cystic lesion mimicking glioma image presentation.Keywords: Cystic meningioma, interhemispheric space, magnetic resonance imaging, diagnosis DOI: 10.15850/ijihs.v4n1.686
ANTERIOR INTERHEMISPHERIC APPROACH FOR OLFACTORY GROOVE MENINGIOMA Hidayat, Imam; Sutiono, Agung Budi; Faried, Ahmad; Arifin, Muhammad Zafrullah
International Journal of Integrated Health Sciences Vol 4, No 2 (2016)
Publisher : International Journal of Integrated Health Sciences

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Objective: To evaluate the surgical technique with bifrontal interhemispheric approach for total removal of tumor in olfactory groove meningioma (OGM). Methods: This study described a case of a 38-year-old woman with bilateral blindness, anosmia, and behaviour changes. Imaging studies show a tumor mass in midfrontal base. Surgery using a bifrontal interhemispheric approach was performed and total removal was achieved and postoperative computed tomography (CT) scan was performed to confirm the result. Histopathological findings established a diagnosis of meningioma.Results: A coronal skin incision behind the hairline was utilized. The scalp was elevated, taking care to reserve the vascularized pericranium medial to the linea temporalis of each side, and preserving the 2 supraorbital nerves. Eight burr holes were used, with the two initial holes made on each side of the orbitotemporal region, and the other four holes at the midline. A bifrontal craniotomy was performed. The tumor was first detached from its attachment with bipolar cautery and debulked. During this step, the main tumor feeder arteries from the anterior and posterior ethmoidal artery were interrupted, and the tumor devascularized. Total tumor removal through surgical intervention was achieved and confirmed by head CT-scan postoperatively.Conclusions: This case report supports the suitability of the bifrontal interhemispheric approach for OGM resection with additional radiation therapy.Keywords: Anterior interhemispheric approach, olfactory groove meningioma DOI: 10.15850/ijihs.v4n2.838