Introduction Hyperbaric oxygen therapy (HBOT), a procedure that involves the patient inhaling 100% oxygen gas under pressure, is currently used as an adjunctive treatment option for certain inflammatory conditions. HBOT can improve wound healing by increasing the rate of angiogenesis in injured tissue by increasing levels of vascular endothelial growth factor (VEGF). VEGF causes re-epithelialization, the migration of endothelial cells, and the formation of granulation tissue, which are involved in the wound healing process. Methods This study contains secondary data analyses of information previously collected in two separate studies, each concerning the effects of HBOT on diabetic foot ulcers and crush injury fractures at Prof. Dr. R. D. Kandou Hospital Manado and Siloam Hospital Manado from 2019 to early 2020. Results Based on the classification tree analysis, the predictors of HBOT success were leukocytes level (34%), platelet count (32%), and age (26%). The conditional inference tree analysis also indicated significant leukocyte levels, age, and platelet counts (p < 0.001), with which the interpretation of these results was the same as the classification tree analysis method. The results obtained from the random forest analysis revealed that the mean value of Gini reduction for leukocytes (207.3), platelets (110.2), age (97.9), and hemoglobin (57.9) can be used as indicators of successful HBOT. These three methods support that age, leukocytes, and platelets are determinants of HBOT success, while hemoglobin levels were only significant in one analysis method. Therefore, a new, proposed algorithm containing these factors was assembled from the results of this study. Conclusion HBOT cannot be separated from specific variables that contribute to and can predict its success.

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Diabetic foot is a chronic complication of diabetes mellitus which is commonly found but very threatening due to its unsatisfied management, usually ended with amputation or death. Sharp debridement is the gold standard of diabetic foot, albeit, it has to be considered wisely due to the metabolic disorder, sepsis, and other comorbid factors of the patients. This study was aimed to compare the dynamics of Il-1α levels in patients with aggresive sharp debridement and with conservative sharp debridement associated with clinical improvement. This was an experimental analytical study. There were 38 patients with diabetic foot admitted at Prof. Dr. R. D. Kandou Hospital Manado with an age range of 30-60 years, obtained by using simple random sampling. The patients were divided inti two groups: aggressive sharp debridement dan conservative sharp debridement, each of 19 patients. Samples for laboratory examination were collected before and after debridement. In consevative sharp debridement group, the mean levels of IL-1α before treatment was 108,158±14,519 pg/ml meanwhile after treatment was 108,526±16,625 pg/ml that showed no significant elevation. In aggressive sharp debridement group, the mean levels of IL-1α before treatment was 93,263±15,172 pg/ml meanwhile after treatment was 104,052±18,807 pg/ml that showed a significant elevation. Conclusion: In patients with diabetic foot, elevation of IL-α levels after aggressive sharp debridement was greater than after conservative sharp debridement.Keywords: diabetic foot, sharp debridement, interleukin 1-αAbstrak: Kaki diabetes merupakan salah satu komplikasi kronik diabetes melitus yang sering dijumpai dan ditakuti oleh karena pengelolaannya sering mengecewakan dan berakhir dengan amputasi, bahkan kematian. Penanganan dengan debridemen tajam pada pasien dengan kaki diabetik merupakan baku emas tetapi masih dipertimbangkan akibat adanya gangguan metabolik, sepsis dan faktor komorbid lainnya. Penelitian ini bertujuan untuk menganalisis tindakan debridement tajam agresif dan konservatif pada pasien kaki diabetik dengan dinamika kadar IL-1α dan hasil perbaikan klinis. Jenis penelitian ialah eksperimental analitik. Populasi penelitian ialah pasien kaki diabetik yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado dengan rentang usia 30-60 tahun. Subjek penelitian diperoleh dengan simple random sampling, terdiri dari 38 pasien, dibagi atas dua kelompok: tindakan debridemen tajam agresif dan debridemen tajam konservatif, masing-masing 19 pasien. Pengumpulan sampel untuk pemeriksaan laboratorik dilakukan sebelum dan setelah masing-masing tindakan. Pada kelompok tindakan konservatif didapatkan rerata nilai IL-1α sebelum tindakan ialah 108,158±14,519 pg/ml sedangkan setelah tindakan ialah 108,526±16,625 pg/ml yang menunjukkan tidak terdapat peningkatan bermakna. Pada kelompok tindakan agresif nilai IL-1α sebelum tindakan ialah 93,263±15,172 pg/ml sedangkan setelah tindakan ialah 104,052±18,807 pg/ml yang menandakan peningkatan bermakna. Simpulan: Peningkatan kadar IL-α setelah tindakan debrideman tajam agresif lebih besar dibandingkan setelah tindakan debrideman tajam konservatif pada penderita kaki diabetik.Kata kunci: kaki diabetik, debridemen tajam, interleukin 1-α

Trauma is reported as the main cause of death, hospitalization, and long-term disability. Blunt thoracic trauma is a common problem in society which can be caused by traffic accidents, fallen from height, impact, and others. This study was aimed to obtain the profile of non-enetrating blunt thoracic trauma in surgery emergency unit of Prof. Dr. R. D. Kandou General Hospital Manado from January 2014 to June 2016. This was a retrospective descriptive study using all medical records of non-penetrating blunt thoracic trauma. The results showed that there were 35 cases of non penetrating blunt thoracic trauma out of a total of 120 cases. The majority of cases occurred in 2014 and 2016 (37.1%); age group 21-30 years (28.5%), and males (85.7%). The most common cause was traffic accidents (74.2%) meanwhile most treatment performed was conservative treatment (77.1%) and the outcome of most non-penetrating blunt thoracic trauma was uncomplicated (77.1%).Keywords: trauma, blunt thoracic trauma Abstrak: Trauma dilaporkan menjadi penyebab utama kematian, perawatan di rumah sakit dan kecacatan jangka panjang. Trauma tumpul toraks merupakan masalah umum bagi masyarakat, yang bisa disebabkan oleh kecelakaan lalu lintas, jatuh dari ketinggian, benturan, dan lain-lain. Penelitian ini bertujuan untuk mendapatkan data tentang trauma tumpul toraks non penetrans di IRDB RSU Prof Dr. R. D. Kandou Manado periode Januari 2014-Juni 2016. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan semua data rekam medik pasien trauma tumpul toraks non-penetrans. Hasil peneltiian mendapatkan jumlah kasus trauma tumpul toraks non penetrans sebanyak 35 pasien dari total 120 pasien dengan kasus terbanyak terjadi pada tahun 2014 dan 2016 (37,1%), kelompok usia 21-30 tahun (28,5%), dan jenis kelamin laki-laki (85,7%). Penyebab tersering ialah kecelakaan lalu lintas (74,2%) sedangkan penanganan yang paling banyak dilakukan ialah penanganan konservatif (77,1%). Hasil akhir trauma tumpul toraks non-penetrans yang didapat umumnya tanpa komplikasi (77,1%).Kata kunci: trauma, trauma tumpul

Massive pleural effusion is a condition in which there is a buildup of fluid beyond normal in the pleural cavum with a volume of two-thirds of one side of the pulmonary field proven with the help of chest X-ray. Drainage of pleural effusion fluid is a management treatment for pleural effusion, but nevertheless it has complications such as pain, bleeding, pneumothorax, and pulmonary edema. Blood gas analysis is simple and essential examination in emergency medicine, which is able to provide valuable information about the acid-base status, ventilation, and oxygenation of a patient. This study aimed to analyze changes in blood acidity (pH), oxygen partial pressure (PaO2) and carbon dioxide partial pressure (PaCO2) in patients with massive pleural effusion at Prof. Dr. R. D. Kandou Hospital, Manado. This was a prospective cohort study with a longitudinal data collection design according to the cohort method. The results of the overall linear regression analysis supported the effect of drainage on PaCO2, PaO2, and pH, and indicated that the relationship between drainage volume and PaO2 was positive. Meanwhile, descriptively and statistically, there was no meaningful relationship between pH and PaCO2 and drainage volume. In conclusion, there is a positive relationship between drainage volume and PaO2, however, there is no significant relationship between pH and PaCO2 with drainage volume.Keywords: massive pleural effusion; pH; PaCO2; PaO2 Abstrak: Efusi pleura masif adalah suatu keadaan dimana terjadi penumpukan cairan melebihi volum normal di dalam kavum pleura dengan volume duapertiga dari satu sisi lapang paru yang dapat dibuktikan dengan bantuan X foto toraks. Drainase cairan efusi pleura merupakan manajemen tatalaksana untuk efusi pleura, namun memiliki komplikasi seperti nyeri, perdarahan, pneumotorak, dan edema paru. Analisis gas darah merupakan pemeriksaan yang sederhana namun esensial dalam ilmu kedokteran gawat darurat, yang mampu memberikan informasi berharga mengenai status asam basa, ventilasi maupun oksigenasi dari pasien. Penelitian ini bertujuan untuk untuk menganalisis perubahan tingkat keasaman darah (pH), tekanan parsial oksigen (PaO2) dan karbon dioksida (PaCO2) pada pasien dengan efusi pleura massif. Jenis penelitian ialah prospektif dengan desain pengumpulan data longitudinal menurut metode kohort di RSUP Prof. Dr. R. D. Kandou Manado. Hasil analisis regresi linear secara keseluruhan menunjang efek volume drainase terhadap PaCO2, PaO2, dan pH dengan hasil hubungan volume drainase dengan PaO2 bersifat positif namun tidak didapatkan hubungan bermakna antara pH dan PaCO2 dengan volume drainage. Simpulan penelitian ini ialah terdapat hubungan positif antara volume drainase dengan PaO2, namun tidak didapatkan hubungan bermakna antara pH dan PaCO2 dan volume drainase.Kata kunci: efusi pleura massif; pH; PaCO2; PaO2