SURGICAL ASPECT OF DIABETIC FOOT (diagnosis , sign, symptoms, and management ) / komplikasi diabetes melitus pada kaki dan penanganannya.

DIABETIC FOOT SURGERY TREATMENT

A. Definition

Diabetes Mellitus (DM) is a hereditary metabolic disease that mostly, demham signs of hyperglycemia and glucosuria, accompanied by clinical symptoms or absence of acute or chronic, as a result of the lack of effective insulin in the body, lies in the primary disorder of carbohydrate metabolism that is usually accompanied too fat and protein metabolism disorders. (Askandar, 2000).

Gangrene is the process or condition that is characterized by the presence of dead or necrotic tissue, but a microbiological process of necrosis is caused by infection. (Askandar, 2001).

B. Classification

A. Diabetes Mellitus

a. Type I diabetes mellitus (IDDM)

Patients are very dependent on insulin due to an autoimmune process that attacks the insulin. IDDM is the type of DM-derived (Inherited).

b. Type II diabetes mellitus (NIDDM)

Type of DM is influenced by both heredity and environmental factors. A person has a substantial risk of suffering from NIDDM if their parents are people with DM and adopt the wrong lifestyle.

c. Gestational DM

DM of this type tend to occur in pregnant women and the family members who are also suffering from DM. Risk factor is overweight or obese.

d. Secondary DM

DM is associated with other conditions or syndromes (pancreatitis, hormonal abnormalities, and drugs).

MY HEAD ENLARGED AND MY SUN SET EYES : HYDROCEPHALUS (definition, anatomy, diagnosis, sign, symptom, and management)

CHAPTER I

INTRODUCTION

Hydrocephalus comes from hydro meaning water and chepalon which means head. Hydrocephalus is a buildup of cerebrospinal fluid (CSS) is actively causing dilatation of the ventricular system of the brain where there is excessive accumulation of CSF in one or more of the ventricles or subarachnoid space. This situation is caused because there is imbalance between production and absorption of the CSS. If the excessive accumulation of CSF occurs on the cerebral hemispheres, a condition called subdural higroma or subdural fluid collection. In the case of excessive fluid accumulation occurs in the ventricular system, a situation known as hydrocephalus internal.Selain that some intracranial lesions causing elevation of ICT, but not until the cause of hydrocephalus. CSS is not equivalent to raising the volume with hydrocephalus; it also occurs in cerebral atrophy.

Hydrocephalus as a clinical entity distinguished by three factors: a). Intraventrikuler pressure elevation, b). Addition of CSS volume, c). Dilatation of the cavity CSS. Overall, the incidence of hydrocephalus is estimated close to 1: 1000. while the incidence of congenital hydrocephalus varies for each of the different populations. BL Hershey said most of hydrocephalus in children is congenital is usually seen in infancy. If hydrocephalus appears after age 6 months is usually not because of congenital. Mujahid Anwar et al get 40-50% of infants with intraventricular hemorrhage grade 3 and 4 had hydrocephalus. Pongsakdi Visudiphan et al in a study 36 of 49 children with TB meningitis had hydrocephalus, with a second note 8 children with obstructive hydrocephalus and 26 children with communicating hydrocephalus. Hydrocephalus that occurs as a complication of bacterial meningitis can be found at any age, but more often in infants than children.

BENIGN OR CANCER (MALIGNANT) PAROTID GLAND TUMOR (definition, sign, symptoms, diagnosis, prognosis, and management

Parotid gland

Anatomy of parotid gland

Parotid gland is the salivary glands are paired, numbered 2. Parotid gland is the largest of the salivary glands. Each weighing an average of 25 grams and irregular shape, berlobus, color between green and yellow (Yellowish) located below the external acoustic meatus between the mandible and the muscles sternokleidomastoideus.4

Parotid gland varied shape, when viewed from the lateral triangular 50%, 30% of the top and bottom round. Parotid gland is usually shaped like an inverted pyramid with a surface-surface as follows: superior surface of the small, superficial, anteromedial, and posteromedial. Konkav on the superior surface forms associated with the cartilage of the external acoustic meatus and the posterior part of the temporomandibular joint. Here auriculotemporal nerve supplies the parotid gland. Superficial surface covered by skin and superficial fascia containing a branch of the facial nerve aurikuler, superficial parotid lymph nodes, and the lower limit of platisma.4

The anterior part of the gland adjacent to the posterior edge of mandibular ramus and slightly coat the posterior edge of masseter muscular. Posterior part of the gland is surrounded by the ear, mastoid processus, and the anterior edge of the muscular stemokleidomastoideus. The inside of the medial lobe extends into the cavity parafaring, limited by the processus stilomandibular stiloideus and ligament, muscular digastrikus, and carotid sheath. In the anterior lobe is located adjacent to the medial ptetygoideus. Lateral parts covered only by skin and subcutaneous fat tissue. Connective tissue and fat tissue from the fascia of the neck in this gland wraps. Parotid gland is closely linked to important structures around the internal jugular vein and its branches, the external carotid artery and its branches, lymph glands, auriculotemporalis of nerve branches and nerve trigerninus fasialis.4