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FINAL RESEARCH EXAM RESEARCH TITLE PROFILE OF TETANUS PATIENTS IN RSUD dr. SAIFUL ANWAR, MALANG IN THE PERIOD OF 2008 - 2010 BY NAVINDRAN A/L THANASAGER 0910714010 SUPERVISOR I : dr. Aulia Abdul Hamid, Msc , Sp.M SUPERVISOR II : dr. Nurul Hidayati , Msc
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FINAL RESEARCH EXAM RESEARCH TITLE PROFILE OF TETANUS PATIENTS IN RSUD dr. SAIFUL ANWAR, MALANG IN THE PERIOD OF 2008 - 2010 BY NAVINDRAN A/L THANASAGER 0910714010 SUPERVISOR I : dr. Aulia Abdul Hamid, Msc, Sp.M SUPERVISOR II : dr. NurulHidayati, Msc EXAMINER : dr. DanikAgustine, Msc
Specific Objectives To identify the number of tetanus patients based on
Tetanus Etiology
Pathophysiology 2-14 days Spinal Cord to the muscle Uncontrolled aCh release Forceful enough to tear muscles apart!
Total number of patients for the variables of tetanus profile for patients admitted in RSUD dr. SAIFUL ANWAR has increased in the period of 2008 – 2010 as compared to the period of 2000 – 2002. Hypothesis
Research Results - Focal Infection 2000 – 2002 2008 – 2010 Highest = Legs (76%) Highest = Legs (80%)
- Cause Of Infection 2000 – 2002 2008 – 2010 Highest = Cuts/Puncture (74%) Highest = Cuts/Puncture(76%)
- Incubation Time 2000 – 2002 2008 – 2010 Highest incubation time = 6 – 10 days (58%) Highest incubation time = 11 – 14 days (61%)
- Age Distribution 2000 – 2002 2008 – 2010 Highest Age distribution = Adults (62%) Highest Age distribution = Elderly (53%)
- Gender 2000 – 2002 2008 – 2010 Highest Gender distribution = Male (74%) Highest Gender distribution = Male (77%)
- Clinical Severity 2008 – 2010 2000 – 2002 Highest clinical severity = Moderate tetanus (54%) Highest clinical severity = Severe tetanus (59%)
- Cause of death 2008 – 2010 2000 – 2002 Highest Cause of death = Respiratory failure (36%) Highest Cause of death = Respiratory failure (44%)
- Treatment 2008 – 2010 Highest choice of treatment = Metronidazole (100%)
- Length of Hospital stay 2008 – 2010 Highest length of hospital stay = less than 4 weeks (82%)
Discussion • Total number of patients • 2000 – 2002 = 81 cases • 2008 – 2010 = 283 cases • number of patients with tetanus disease past 6 years since 2002 in Malang. • 2) Focal Infection (leg) • 2000 – 2002 = 31 cases • 2008 – 2010 = 219 cases • awareness among people wear shoes or slippers while working or walking. • chance of infection open wounds .
3) Cause of Infection (cuts / puncture) • 2000 – 2002 = 65 cases • 2008 – 2010 = 216 cases • Unwillingness of people to wear sandals or shoes • While walking on bare grounds cuts or puncture objects contaminated by clostridium tetanibacteria • 4) Incubation time (6 – 10 days) • 2000 – 2002 = 28 cases • 2008 – 2010 = 165 cases • Willingness of public treatment in hospital when early signs begin to show rather than the disease become severe.
5) Age distribution • adults > elderly age group • Due to economic factor • hard labor for construction works adults • Susceptible for wound infliction • 6 ) Gender • Male >> than female • Occupation factor • Male job active >> to females, wound infliction prevalent. • 7) Clinical severity • moderate cases >> to severe tetanus • Shift due to improvement of service, management, and treatment medical personal.
8) Cause of death • Respiratory failure • Sepsis as compared to 2000 – 2002 • negligence of patients to proper treatment for open wounds • Wound gets infested Clostridumtetanibacteria • Severe inflammatory response = sepsis. • 9) Total number of deaths • compared to 2000 – 2002 • ( 122 : 42) • in mortality rate • Deaths coherently with the number of patients admitted • 10) Treatment • Metronidazole • Gold standard antibiotic for tetanus • penetrating capabilities dead tissue • Diazepam used as anticonvulsants and muscle relaxants muscle spasms.
11) Length of Hospital stay • <4 weeks • Prognosis of the disease • People who develop symptom within a few days to 100 % mortality rate. • Sooner the individual treated, the more likely to survive. • Recovery 2 – 4 weeks.
Conclusion • Number of patients and mortality rate since 2002. • Focal infection leg cuts and puncture is the cause of infection. • Clinical severity moderate tetanus deaths respiratory failure • Adult males >> females and other age group • Treatment Metronidazole theory • hospital 4 weeks short & rapid theory.
Recomendation • RSUD dr. SAIFUL ANWAR, Malang, must improve quality of curative effort as proper management of open wound debridement sepsis proper treatment • Management to store accurate information patients computerized manner. • All interventions taken patient recorded medical record prevent miscommunication. • Provoke primary health center preventive measures immunization people inner region , adults and pregnant mothers. • Conduct study profile of tetanus patients admitted every year data updated.
Thank You TerimaKasih MaturNuwun Syukriya