BACKGROUND: Maxillofacial fracture is one of the major trauma; the cases were increasing because of the high number of motorcycles in Bali. The goal of the treatment is proper positioning of the occlusion, and it depends on rapid diagnosis and proper treatment. AIM: This study aims to know the characteristics of the maxillofacial fracture patients in Sanglah General Hospital Denpasar Bali. METHODS: A retrospective study, based on medical record were concluded, samples taken in Sanglah General Hospital from January to June 2015. Total recorded patient were 35 patients. The data obtained include age, gender, type of the fractures, and operation management. RESULTS: The injury was more common in male compared to female (80% vs 20%). Age 20 to 40 years old were more common (48.57%), followed by the child to adolescent (aged 0 to 20 years old) were 31.43%, and adult to elderly (aged 40 to 60 years old) was 20%. The mandibular fracture was most common (51.43%), other fractures such as a zygomatic fracture (31.43%) and maxillary fracture (17.14%). Internal fixation was the gold standard of the treatment (65.71%), and the other was an arch bar (34.29%). CONCLUSION: Diagnosing the right injury to the facial bone is a key step in determining a treatment plan. Rapid diagnosis and proper treatment lead to good occlusion, both internal fixation and arch bar were an effective treatment. The importance of dealing with almost all maxillofacial fracture problems in the first surgery.

Background: Sepsis is a leading cause of death worldwide. A delayed or missed diagnosis of sepsis could increase its morbidity and mortality. The abdomen is the most common source of sepsis, which known as peritonitis-induced-sepsis. Peritonitis leads to an inflammatory and anti-inflammatory response. This study aims to elaborate on the role of Neutrophil Lymphocyte Ratio (NLR) as an easy, fast and inexpensive infection marker compared to blood culture, which known as the gold standard of sepsis in peritonitis patients. Methods: This is a diagnostic study which combined secondary data taken at Sanglah Hospital Medical Record Department and new cases of generalized peritonitis patients with sepsis who came to Surgical Emergency Unit of Sanglah Hospital as the subjects. A total of 86 subjects, complete blood count analysis was done to calculate NLR. Besides, 2-sided blood culture was tested to see whether the results were positive or negative. Data were analyzed using Stata/SE version 12.1Results: We found that sensitivity of NLR compared to blood culture was 80% (CI:63.1-91.6), with specificity of 88.2% (CI:76.1-95.6), positive predictive value of 82.4% (CI:65.5-93.2), negative predictive value of 86.5% (74.2-94.4), accuracy of 84.9% and likelihood ratio (LR) positive value of 6.8>1. Our results showed that NLR has an enormous value in predicting the occurrence of sepsis in patients with generalized peritonitis. Conclusion: NLR can be used as a screening tool for sepsis in generalized peritonitis patients because it has better sensitivity and accuracy, but it has to confirmed by blood culture as the gold standard. Latar belakang: Sepsis merupakan penyebab kematian diseluruh dunia. Keterlambatan atau kesalahan dalam mendiagnosis dapat menyebabkan peningkatkan morbiditas dan mortalitas. Abdomen merupakan sumber penyebab paling sering terjadinya sepsis yang disebut dengan sepsis diinduksi peritonitis (peritonitis-induced sepsis). Penelitian ini bertujuan untuk menguji kemampuan Neutrophil Lymphocyte Ratio (NLR) sebagai marker infeksi yang mudah, cepat dan murah dibandingkan kultur darah yang merupakan standar baku dalam mendiagnosis sepsis pada pasien peritonitis.Metode: Rancangan penelitan yang digunakan dalam penelitian ini adalah uji diagnostik dengan subjek penelitian  merupakan gabungan antara data sekunder yang diambil di Instalasi Rekam Medis RSUP Sanglah serta identifikasi kasus baru yaitu pasien sepsis pada peritonitis generalisata yang datang ke IRD Bedah RSUP Sanglah sehingga jumlah total sampel 86 orang. Pasien kemudian diambil darah lengkap untuk nilai NLR dan kultur darah 2 sisi apakah hasilnya positif atau negatif. Data dianalisis menggunakan Stata/SE versi 12.1Hasil:   Dari penelitian ini didapatkan sensitifitas NLR dibandingkan dengan kultur darah adalah sebesar 80% (CI: 63,1-91,6) dengan spesifitas 88,2% (CI: 76,1-95,6), nilai prediktif positif 82,4% (CI: 65,5-93,2), nilai prediktif negatif 86,5% (CI: 74,2-94,4) dan akurasi 84,9%, serta nilai likelihood ratio (LR) positif didapatkan 6,8>1. NLR mempunyai nilai yang besar dalam meprediksi terjadinya sepsis pada pasien peritonitis generalisata.Simpulan: NLR dapat digunakan sebagai skrinning pasien sepsis pada peritonitis generalisata karena memiliki sensistifitas dan akurasi yang lebih baik tetapi tetap dikonfirmasi dengan kultur darah sebagai standar baku.

Aim: To know the patterns of fracture site and management of maxillofacial cases in the Department of Trauma and Acute Care Surgery in Sanglah General Hospital Denpasar Bali. Methods: this is a retrospective study, based on medical record were concluded, samples taken in Sanglah General Hospital from January 2012 to December 2018. All of maxillofacial trauma medical records were taken. The data of age, gender, patterns of fractures site and management were taken and described. Results: There were total of 257 cases of maxillofacial trauma managed in the Department of Trauma and Acute Care Surgery in Sanglah General Hospital. Two-hundred and forty-one medical records of maxillofacial trauma were included in this study. About 16 medical records were excluded due to incomplete medical records and could not be contacted. Mostly cases found in male, aged 18-40 years old. The site of fractures majorly located in the mandible (60.12%). About 48% fractures were identified at symphysis or parasymphysis of mandible, followed by the body and angular of mandible. Open reduction and internal fixation (ORIF) were the gold standard of the treatment (83,73%) followed by Archbarr (16,27%). Conclusion: The most common site of maxillofacial fracture was mandible, specifically at symphysis or parasymphysis part. ORIF miniplate, together with Archbarr and interdental wiring fixation were the most common modality of management.

Tujuan: untuk mencari validitas new injury severity score (NISS) dalam mendeteksi koagulopati akut pada pasien multiple trauma. Metode: penelitian ini adalah uji diagnostik dengan rancangan cross sectional, dilakukan untuk mencari validitas NISS dalam mendeteksi terjadinya koagulopati akut pada 61 pasien multiple trauma dengan ISS >16. Penelitian dilakukan di RSUP Sanglah Denpasar sejak bulan Januari 2014 hingga November 2015. Data dianalisis dengan menggunakan kurva ROC dan uji diagnostik tabel 2x2 sehingga didapatkan area under curve, cut off point, sensitifitas, spesifisitas, nilai prediksi positif, nilai prediksi negatif, rasio kemungkinan positif, dan rasio kemungkinan negatif. Hasil: didapatkan cut off point NISS 41 dengan AUC 0,8851 (>0,7). Sensitifitas dan spesifisitas NISS cukup baik dalam mendeteksi terjadinya koagulopati akut pada pasien multiple trauma yaitu sebesar 79,2% dan 91,8% (CI 95%: 0,78-0,98). Hasil nilai prediksi positif 86,4%, nilai prediksi negatif 87,2%, rasio kemungkinan positif 9,76 dan rasio kemungkinan negatif 0,227 mendukung bahwa nilai diagnostik NISS cukup baik. Simpulan: validitas NISS cukup baik dalam mendeteksi terjadinya koagulopati akut pada pasien multiple trauma.