No abstract

Background: The management of anorectal malformations universally uses posterior sagittal anorectoplasty (PSARP) as standard surgery. The aim of this research was to determine continence in patients with anorectal malformation after PSARP action.Methods: This study was a descriptive analytical categorical research with cross sectional design. The data were obtained from patients’ medical records and questionnaire given to patients underwent PSARP in Wahidin Sudirohusodo Hospital and network hospitals from June 1 to December 1, 2018. The analysis was done to 60 children ranging from 5 to 8 years old. Most of them were male (56.7%) ranging from 5 to 6 years old (53.3%).Results: The results of the research indicated that based on malformation subtype, most of them suffered from rectourethra fistula (40.0%) with continence problem (61.7%). There was no significant correlation between sex and continence problem (p >0.05). However, it was seen that the percentage of continence subjects was higher in female (65.4%) than in male (58.8%), while the percentage of soiling and constipated subjects was higher in male than in female. Rectourethra fistula was found more frequently in male than in female (70.6%), while vestibuler fistula was found more frequently in female (69.2%). There was no significant correlation between age and defecation problem (p >0.05). However, the percentage of continence and soiling subjects was higher in 5-6 years children then the one for 7-8 year children, while the percentage of constipated subjects was higher in 7-8 year children (21.4%) than 5-8 year children (18.8%).Conclusions: Gender differences in the outcome of children with anorectal malformations must be considered. Men with perineal fistula were likely to experience continence and constipation than women with perineal fistulas. Women with perineal fistulas and vestibular fistulas had almost similar outcome.

Background: Inhalation trauma is the leading cause of death in burn patients. Inhalation trauma is caused mainly by inhalant poisons such as smoke, gas and steam. Many patients die immediately at the scene due to inhalation trauma. The purpose of this study was to determine the relationship between comorbid factors and mortality rates in patients with inhalation trauma.Methods: The research design was analytical research method with cross sectional design. The study sample consisted of 26 people (51.0%) inhalation trauma and 25 people (49.0%) without inhalation trauma obtained by consecutive sampling.Results: There was a significant relationship between inhalation trauma and death outcomes (p<0.001). The proportion of deaths in inhalation trauma (65.4%) was significantly higher than in nonhaled trauma (16.0%). There was no significant relationship between DM and outcome (p>0.05). There was no significant relationship between hypertension and outcome of death (p>0.05). There is a significant relationship between onset and outcome (p<0.05). The proportion of deaths at <24 hours onset (35.6%) was significantly lower than at onset >24 hours (83.3%). The mean blood glucose level of dead patients was higher than that of alive, which was 124.4 compared to 114.9 but was not statistically significant (p>0.05). Both the mean systole and diastole pressures of the dead patients showed significantly lower results than that of alive, i.e., the mean systole was 101.2 compared to 114.1 (p<0.05) and the mean diastole was 62.2 versus 71.4 (p<0.05).Conclusions: According to the results of the study, it was found that there was a relationship between the onset of more than 24 hours, high GDS levels, and lower blood pressure to mortality.