Yoyos Dias Ismiarto
Departement of Orthopaedi and Traumatology, Faculty of Medicine, Universitas Padjadjaran/ Dr. Hasan Sadikin General Hospital, Bandung

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Concomitant Distal Radioulnar Joint Disruption in Distal End Radius Fracture Cases Admitted to Emergency Ward Hasan Sadikin Hospital January 2013 – December 2015 Pinandita, Tody; Herman, Herry; Ismiarto, Yoyos Dias
Berkala Kedokteran Vol 15, No 1 (2019)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v15i1.6090

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Abstract: The distal end radius and ulna is an integral part of the wrist joint and preservation of its normal anatomy is essential for the mobility of the wrist. The most common cause of residual wrist disability after distal end radius fractures is the disruption of distal radioulnar joint (DRUJ). Early recognition and management in the acute stage aim at the anatomic reconstruction of the DRUJ in an effort to reduce incidence of chronic pain and loss of wrist motion. The purpose of this study is to identify the prevalence of accompanying DRUJ in distal end radius fracture cases, highlighting its significance in occurance. This was a retrospective study with an analytic descriptive method and data from January 2013-December 2015 taken from medical records of Dr. Hasan Sadikin Hospital. From research, we found 74 cases of distal end radius fracture. The most common injured wrist were dominant hand as 46 cases (62,2%), and non-dominant hand as 28 cases (37,8%). From all data, DRUJ disruption were marked as 37 cases (50%). Extraarticular fracture with concomitant DRUJ disruption were marked in 3 cases (8,1%) and in intraarticular involvement were 34 cases (91,9 %). From this study, we can conclude that half of the distal end radius fracture cases, especially intraarticular, were accompanied by DRUJ  disruption. This should be an issue to be concerned by the physician when evaluating distal end radius fracture cases and to perform proper treatment.
RELATIONSHIP OF ACL INJURY WITH POSTERIOR TIBIAL SLOPE, INTERCONDYLAR NOTCH WIDTH RATIO, AGE, AND SEX Priono, Boby Harul; Utoyo, Ghuna Arioharjo; Ismiarto, Yoyos Dias
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol 7, No 2 (2018): JOINTS
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (793.834 KB) | DOI: 10.20473/joints.v7i2.2018.106-113

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Posterior tibial slope (PTS) has been proposed as a potential risk factor for ACL injury; however, studies that examined this relationship have provided inconclusive and sometimes contradictory results. Further characterization of this relationship may enable the medical community to identify individuals at greater risk for ACL injury and possibly characterize an anatomic target during surgical reconstruction. Medical records of 20 patients who underwent MRI of the knee and athroscopy procedure between August 2016 and March 2017 were reviewed. Patients were separated into 2 groups: a study group of those subjects who had undergone surgery for ACL injury (n =10) and a control group of patients diagnosed without ACL Injury (n = 10). Demographic data were collected, and MRI images from both groups were analyzed using protactor android imaging software to obtain PTS measurements. Data then analyzed using SPSS v20. Data analysis demonstrated that the ACL injury group had significantly greater values for PTS (14.4 SD ± 3.5) compared with controls (10.1 SD ± 2.6). After stepwise elimination of non significant variables, the final t test independent determined that PTS (p value 0.08; p < 0.1) had statistically significant relationships with ACL injury. INW ratio, age, and sex were not demonstrated to be significant predictors of ACL injury in this final model. This study showed a relationship between increased PTS and ACL injury, which corroborates the findings of previously published studies. INW ratio, sex, and age showed no significant relationship with ACL injury.
Comparison between Use of Antibiotics and Argentum (Ag) in Infected Wound Healing Ismiarto, Yoyos Dias; Husain, Fadlyansyah Farid; Farry, Farry
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 (5307.8 KB) | DOI: 10.15395/mkb.v51n1.1429

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Infected wound is a common problem encountered in the field of Orthopedics. Various procedures have been applied in order to achieve the effective treatment for wound infection. However, until recently, the biomolecular responses to those remain unclear. This study aimed to compare the effectiveness of antibiotics and argentum in infected wound healing by analyzing the FGF-2 and FGF-7 expressions; fibroblasts; bacteria colonization; and wound contraction rate during the proliferation phase of wound healing. This study was performed from May to September 2016 at the Pharmacology Research Laboratory, Faculty of Medicine, Padjadjaran  University. A randomized clinical laboratory experimental trial with repetitive measures was performed in male rabbits that had been wounded and inoculated by 0.5 MF Staphylococcus aureus. Sample was collected before(Day 6) and after (Day 14) the application of antibiotics and argentum. The consecutive sampling method was used to determine the two treatment groups: (I) antibiotic group and (II) argentum group.  The argentum group showed higher FGF-2 protein level, FGF-7 protein level, fibroblast count, and wound contraction rate with p<0.05 when compared to the antibiotic group. The use of argentum gave excellent responses to wound repair as indicated by elevated FGF-2 and FGF-7 levels; fibroblast counts; and wound contraction rate. The combination of both treatments might give synergistic responses and  better results in healing infected wound. Argentum is more effective than antibiotics to increase the FGF-2 and FGF-7 levels; fibroblasts count; and wound contraction rate in the proliferative phase of infected wound healing. Antibiotics are more effective than argentum to decrease bacteria colonization.Key words: Bacteria colonization, FGF-2 protein, FGF-7 protein, fibroblast count, wound contraction rate Perbandingan antara Penggunaan Antibiotik dan Argentum (Ag) dalam Penyembuhan Luka Terinfeksi Luka terinfeksi sering kali kita temui dalam permasalahan di bidang orthopedi. Berbagai jenis prosedur ditemukan untuk mengurangi angka kejadian infeksi, namun belum sesuai dengan yang diharapkan. Tujuan penelitian ini adalah membandingkan efektivitas antibiotik dengan argentum dengan menilai ekspresi dari FGF-2, FGF-7, fibroblasts dan rerata kotraksi luka saat fase proliferasi penyembuhan luka. Penelitian ini dilakukan selama bulan Juni hingga September 2017 di Laboratorium Penelitian Farmakologi Fakultas Kedokteran Universitas Padjadjaran. Dilakukan pada kelinci jantan yang telah terluka dan diinokulasi oleh Staphylococcus aureus sebanyak 0,5 MF. Sampel diambil hari ke-6 dan ke-14 aplikasi antibiotik dan argentum. Dengan metode sampling berurutan di tiap-tiap kelompok perlakuan: (I) kelompok antibiotik; dan (II) kelompok argentum. Kelompok Argentum menunjukkan tingkat protein FGF-2, protein FGF-7, jumlah fibroblas dan tingkat kontraksi luka yang lebih tinggi dengan p <0,05 dibanding dengan kelompok Ab. Penggunaan argentum memberikan respons yang sangat baik terhadap perbaikan luka seperti yang ditunjukkan oleh peningkatan kadar FGF-2, FGF-7, jumlah fibroblast, dan tingkat kontraksi luka. Kombinasi kedua pengobatan mungkin memberikan respons sinergis dan memberikan hasil yang lebih baik dalam penyembuhan luka yang terinfeksi. Argentum lebih efektif daripada antibiotik untuk meningkatkan kadar FGF-2 dan FGF-7, jumlah fibroblas, dan tingkat kontraksi luka dalam fase proliferatif dari penyembuhan luka yang terinfeksi. Antibiotik lebih efektif daripada argentum untuk menurunkan kolonisasi bakteri.Kata kunci : FGF-2 protein, FGF-7 protein, jumlah fibroblast, kolonisasi bakteri , rata-rata penyembuhan luka
THE EFFECTIVENESS OF ZINC AND RISEDRONATE ON BONE TURNOVER IN RAT MODEL OF OSTEOPOROSIS ASSESSED WITH THE EXPRESSION OF β-CROSSLAPS Fajar, Adam; Chaidir, Mohammad Rizal; Mulyadi, Dicky; Ramdan, Ahmad; Ismiarto, Yoyos Dias
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol 7, No 2 (2018): JOINTS
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (926.312 KB) | DOI: 10.20473/joints.v7i2.2018.114-124

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Background: Osteoporosis prevalence in Indonesia is high. Risedronate commonly used for treating the osteoporosis. Unfortunately, long term therapy can cause hazardous adverse effect to the patient. Previous research in rat model osteoporosis, Zinc have a potential effect to prevent and rebuild bone structure with osteoblast stimulation in bone formation and osteoclast activity inhibition in bone resorption by increasing Osteoprotegerin production, that inhibit bond between RANKL and RANK.Purpose: To determine the effectiveness of Zink and Risedronate on bone turnover in osteoporotic model rats assessed the ?-CrossLaps expression.Methods: This research is conducted as experimental comparative method used 25 female Galur Wistar rat that divided into Non-ovariectomy and Ovariectomy group to induce osteoporosis. The treatment is divided into Zinc-Risedronate, and Zinc, or Risedronate only. One Way Anova and Independent T-test was used to analyzed the significant difference between groups.Result: One Way Anova statistic test for?-CrossLaps expression value in the 3rd Taken blood sample showed that p is less than 0.05 (p<0.05), which indicated that are significant difference in the mean between variable at 3rd Taken blood sample in all group. Meanwhile, Independent T-test was used to compare ?-CrossLaps expression in 3rd taken blood sample between Ovari and Ovari+Zinc, Ovari and Ovari+Zinc+Rise showed p is less than 0.05 (p<0.05), which indicated that there are significant difference in the mean between variable 2 groups.Conclusion: Zinc-Risedronate administration will decrease bone turnover and ?-CrossLaps expression more than Zinc or Risedronate only in rat model osteoporosis.
Cruris Fracture among Child Patients in Dr. Hasan Sadikin General Hospital Bandung Chandra, Wenny Dwi; Ismiarto, Yoyos Dias; Tahid, Alwin; Hidayat, Nucki Nursjamsi
Althea Medical Journal Vol 2, No 2 (2015)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (704.771 KB)

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Background: Cruris are lower extremity fractures commonly found in children. These dangerous fracturesmay alter the quality of life of the patients. This study was conducted to explore the characteristics of crurisfractures in children.Methods: A descriptive cross-sectional study was performed by reviewing the medical records of childrenwho were hospitalized at the Department of Orthopaedi and Traumatology, Dr. Hasan Sadikin GeneralHospital Bandung during 2010–2011.Results: On two years study, 62 cases have been reported. Most cases occurred among senior high schoolgroup (37.1%). Boys (71.0%) have a higher rate of fractures than girls. Fractures most frequently occurredby traffic accidents (87.1%). The fractures are mostly open (58.1%). The common fracture site was tibia(50.0%) rather than fibula (3.2%) and the most frequent location was on the right side (79.0%) and on themiddle third of the leg (41.9%). Majority of the patients went home in good condition (79.0%).Conclusion: Fractures are most frequently occurred in April because of high humidity. The causes anddistribution of the fractures based on diagnosis were related to another study. Furthermore, additionalstudies are needed to explore the characteristics of cruris fracture among children, not only in certainhospital but also in Indonesia especially in West Java.[AMJ.2015;2(1):276–80]
Complications of Fracture Treatment by Traditional Bonesetters in West Java, Indonesia Warman, Putri Liana; Ismiarto, Yoyos Dias; Ruhimat, Undang
Althea Medical Journal Vol 5, No 1 (2018)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (577.814 KB) | DOI: 10.15850/amj.v5n1.1336

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Background: Traditional medicine practices are still occurring especially in developing countries such as Indonesia. One of the traditional practitioners is the traditional bonesetter (TBS). Due to lack of knowledge of human anatomy, physiology, infection prevention and control, the practices of the TBS has a risk to increase the complications in fractured patients. The objectives of this study was to identify the complications of fractured patients treated by the TBS who were admitted to dr. Hasan Sadikin General Hospital in West Java, IndonesiaMethods: This descriptive study involved 86 medical records of fractured patients admitted to the hospital, from January to December 2014. The collected data were gender, age, admission time after occurrence of the fracture, site of the fracture and early or delayed complications. Moreover, those data were analyzed and presented using frequency tabulation. Results: Out of 86 patients; 61 (70.93%) were males; 16 (18.60%) were 21–30 years old; 25 (29.07%) had fractures 1–3 months before admitted to the hospital; 83 (96.51%) had closed fractures. There were 86 patients with 109 fractures location; 66 (76.74%) had fractures in one location; 41 (37.61%) had femoral fractures. Half of the patients had malunion.Conclusions: The most complication is malunion. 
Role of Kletik oil, Ginger and Garlic Extracts towards Soft Tissue Injury Qing Nan, Benjamin Yong; Ismiarto, Yoyos Dias; Sugianli, Adhi Kristianto
Althea Medical Journal Vol 3, No 3 (2016)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (137.926 KB)

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Background: There is an increased consumption of herbal medicines throughout the world as an alternative treatment for curing health problems. Several herbal medicines are believed to contain anti-inflammatory properties that could trigger healing process. But little is known about the combination effect of herbal medicines. Therefore, the objective of the study was to determine the effects of garlic, ginger and coconut oil (kletik oil) on soft tissue injury (swelling).Methods: The study was held in the research laboratory of Faculty of Medicine Universitas Padjadjaran, from 24th September until 1st October 2014. This experimental study used 7 healthy rabbits (Lepus curpaeums, ±2.5kg) as animal models for each control and intervention group with induced soft tissue injury in the dorsal ear to mimic swelling (inflammation). The mixture of herbs was applied on the injured site in the trial group, while the healing process was denoted by the thickness of edema and time of observation. The data was analyzed using Wilcoxon test.Results: The study results showed that after observation time of 0.5 hour, 2 hours, and 5 hours, edema thickness was unvaried. Onset of action of the herbal mixture began 24 hours after induced injury, with significant difference of edema thickness on both groups; hence the p-value 0.019 (p<0.05).Conclusions: The herbal mixture of ginger, garlic, and coconut oil (kletik oil) contains anti-inflammatory properties to enhance the healing process of soft tissue injury. [AMJ.2016;3(3):421–4]DOI: 10.15850/amj.v3n3.870 
Relationship between Nutritional Status and Flat Foot in Children Fung, Joyce Phua Pau; Ismiarto, Yoyos Dias; Mayasari, Wulan
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (86.904 KB)

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Background: Pediatric flatfoot has been reported as the highest clinical complains for foot problems in pediatric department. Nutritional status has showed great influence on the occurrence of flat foot. There are many debates regarding whether underweight or overweight children are more prone to flatfoot. The aim of this study was to analyze the relationship between nutritional status and flatfoot in children.Methods: A cross sectional study was conducted from July to October 2015 in 3 primary schools in Kecamatan Jatinangor. There were 259 children of grade 4 to 5 included in this study. Flatfoot screening was based on measurement of footprint and calculation using Chippaux-smirak index (CSI). The height and weight of children were measured to obtain their Body Mass Index (BMI). Nutritional status was classified based on CDC BMI-for-age growth charts. Analysis was done using chi-square test.Results: There was significant association between nutritional status and flatfoot with p value<0.001.The prevalence of flatfoot in children grade 4to5is40%. When compared to the normal weight children, the overweight children showed prevalence ratio of 1.97(95% CI:1.47 to 2.64) while the underweight children showed prevalence ratio of 1.34 (95% CI:1.78 to 2.25).This stated that the risk of developing flat foot was higher in overweight children.Conclusions: There is significant association between nutritional status with children grade4 to 5. Overweight children are more prone to flat foot. [AMJ.2017;4(1):152–6] DOI: 10.15850/amj.v4n1.1038
Efek Pemberian Meloxicam Yang Diberikan Selama Fase Inflamasi Terhadap Proses Penyembuhan Tulang Tikus Paska Open Reduction Internal Fixation K-Wire Dinilai Secara Radiologis Pinandita, Tody; Ismono, Darmadji; Ismiarto, Yoyos Dias; Chaidir, M Rizal
Jurnal Sistem Kesehatan Vol 3, No 3 (2018): Volume 3 Nomor 3 Maret 2018
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (339.044 KB) | DOI: 10.24198/jsk.v3i3.16989

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Salah satu faktor yang menyebabkan terjadinya delayed union atau nonunion  pada kasus fraktur adalah pemberian OAINS seperti Meloxicam, namun Meloxicam tetap harus diberikan selama fase inflamasi untuk mengurangi rasa nyeri dan reaksi inflamasi. Tujuan penelitian   untuk menganalisis efek Meloxicam terhadap pembentukan kalus paha tikus yang diberikan selama fase inflamasi paska open reduction internal fixation K-wire dinilai secara radiologis. Penelitian merupakan uji eksperimental laboratorium pada 33 tikus jantan dengan metode pengambilan sampel rancang acak sederhana. Penelitian dilakukan di Bagian Farmakologi Klinik FK-Unpad, Departemen/SMF Orthopaedi dan Traumatologi FK Unpad/RSHS Bandung dan Departemen/SMF Radiologi FK Unpad/RSHS Bandung, mulai dari 25 Juli 2017 hingga 7 September 2017. Penelitian menunjukkan kelompok kontrol dan perlakuan I (Meloxicam 7 hari) memiliki skor Tiedeman  lebih baik dibandingkan kelompok perlakuan II (Meloxicam 30 hari) pada hari ke-30 (p < 0.05) dan ke-45 (p < 0.05), diameter kalus kelompok kontrol dan perlakuan I lebih baik dibandingkan perlakuan II pada hari ke-30 (p <0.05) dan hari ke-45 (p < 0.05), volume kalus kelompok kontrol dan perlakuan I lebih baik pada hari ke-30 (p < 0.05) dan hari ke-45 (p < 0.05). Kesimpulan penelitian adalah pemberian Meloxicam selama fase inflamasi paska ORIF intramedullary K-wire setelah terjadi fraktur, tidak mempengaruhi proses penyembuhan fraktur.Kata kunci : Meloxicam, paska ORIF,  fase inflamasi, penyembuhan fraktur
Histopathological Effects of Ageratum Leaf Extract (Ageratum Conyzoides) on Wound Healing Acceleration After Acute Excisional Wound on Epidermis in Type 2 Diabetes Mellitus Model of Sprague Dawley Rats (Rattus norvegicus) Yudhantoro, Liliek; Hidajat, Nucki Nursjamsi; Ismiarto, Yoyos Dias; Ismono, Darmadji
Majalah Kedokteran Bandung Vol 51, No 3 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n3.1652

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Diabetic wound healing problem often occurs if proper care is not given which will lead to the development of a chronic wound. Ageratum (Ageratum conyzoides L.) leaves is one of the most common plants in tropical areas, including Indonesia, which are frequently used in traditional treatment due to its anti-bacterial properties. This experimental study aimed to identify the effects of topical application of Ageratum leaf extract on wound healing based on histopathological examination of the reepithelization, ulceration, neovascularization, and the presence of inflammatory cells. This study was performed in the period of September to December 2017 at the Pharmacology and Pathology Anatomy laboratories of Dr. Hasan Sadikin General Hospital Bandung, Indonesia. Excisions were made on the back of the 36 rats that were divided into control and test groups. The test group then received a topical application of Ageratum leaf extract. The resulting histopathologic appearance of the wound was then examined. The test group showed better wound healing in all parameters inspected when compared to the control group. Mann-Whitney Test with 95% confidence interval (p<0.05) showed that the re-epithelialization, ulceration, neovascularization, and presence of inflammatory cells reflected a statistically significant improvement in the test group (p=0.319, p=0.290, p=0.251, and p=0.245, respectively). This study concludes that the topical application of Ageratum leaf extract has a statistically significant benefit on diabetic wound healing.Pengaruh Histopatologis Ekstrak Daun Ageratum (Ageratum Conyzoides) terhadap Akselerasi Penyembuhan Luka Setelah Luka Eksisi Akut pada Epidermis pada Model 2 Diabetes Mellitus Tikus Sprague Dawley (Rattus norvegicus) Luka diabetes sering menyebabkan luka kronik jika tidak mendapat penanganan yang tepat. Ageratum (Ageratum conyzoides) merupakan tanaman khas daerah tropis termasuk Indonesia, yang daunnya digunakan untuk pengobatan tradisional karena mengandung zat anti bakteri. Penelitian eksperimental ini menggunakan desain kelompok kontrol post-test untuk mengidentifikasi efek aplikasi topical dari ekstrak daun Ageratum pada penyembuhan luka dengan pemeriksaan histopatologis dari reepitelialisasi, ulserasi, neovaskularisasi, dan sel radang. Penelitian ini dilakukan antara September hingga Desember 2017 di laboratorium Farmakologi dan Patologi Anatomi Rumah Sakit Umum Dr. Hasan Sadikin Bandung. Eksisi dilakukan pada tiap-tiap tikus dari 36 tikus yang dibagi menjadi kelompok kontrol dan kelompok uji di mana kelompok uji dilakukan perawatan dengan ekstrak etanol daun ageratum secara topikal. Setelah diaplikasikan ekstrak daun Ageratum, luka diperiksa secara histopatologi. Observasi pada kelompok uji menunjukkan penyembuhan luka eksisional tikus diabetes yang lebih baik daripada kelompok control untuk semua parameter. Uji Mann-Whitney dengan interval kepercayaan 95% (p <0,05) menunjukkan bahwa nilai p untuk reepitelisasi, ulserasi, neovaskularisasi, dan sel radang adalah p=0,319, p=0,290, p=0,251, dan p=0,245. Aplikasi topikal dari ekstrak daun Ageratum memiliki manfaat pada penyembuhan luka diabetes dan hasilnya signifikan secara statistik.