MALE INFERTILITY

<span style="font-family: "century gothic";"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTWsD67WkzePSk2ETmhTRFGR-8oy4VXKX1FEp-lvHrDMj-cUIhU3kHkK4J0XJLciEFyoTisfgMOEcOP_QI6UWyHQtvs9GVqT3szcIXmadNAo_hRzgU1JXnSbIEbeFDpHcbzMkQw7Odix0/s1600/Screen+Shot+2019-08-01+at+11.20.15+AM.png" imageanchor="1"><img border="0" height="160" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTWsD67WkzePSk2ETmhTRFGR-8oy4VXKX1FEp-lvHrDMj-cUIhU3kHkK4J0XJLciEFyoTisfgMOEcOP_QI6UWyHQtvs9GVqT3szcIXmadNAo_hRzgU1JXnSbIEbeFDpHcbzMkQw7Odix0/s320/Screen+Shot+2019-08-01+at+11.20.15+AM.png" width="320" /></a></span><br /> <span style="font-family: "century gothic";"><br /></span> <span style="font-family: "century gothic";"><a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/cYXblrLdu9rJpz%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/male-infertility-159629747" title="Male Infertility" target="_blank">Male Infertility</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/cYXblrLdu9rJpz" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> </a></span><br /> <div style="margin-bottom: 5px;"> <span style="font-family: "century gothic";"><a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/cYXblrLdu9rJpz%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/male-infertility-159629747" title="Male Infertility" target="_blank">Male Infertility</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><strong> </strong></a><strong><a href="https://www.slideshare.net/Ekoindra4/male-infertility-159629747" target="_blank" title="Male Infertility">Male Infertility</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </span></div> <span style="font-family: "century gothic";"> </span> <br /> <br /> <span style="font-family: "century gothic";">“Infertility is the inability of a sexually active, non-contracepting couple to achieve spontaneous pregnancy in one year” – WHO</span><br /> <span style="font-family: "century gothic";"><br /></span> Male fertility can be impaired as a result of:<br /> <span style="font-family: "arial";">•</span><span style="font-family: "century gothic";">Congenital or acquired urogenital abnormalities</span><br /> <span style="font-family: "arial";">•</span><span style="font-family: "century gothic";">Malignancies</span><br /> <span style="font-family: "arial";">•</span><span style="font-family: "century gothic";">Urogenital tract infections</span><br /> <!--StartFragment--> <!--EndFragment-->

MALE INFERTILITY

Male Infertility from Eko indra “Infertility is the inability of a sexually active, non-contracepting couple to achieve spont...

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LASER TECHNIQUE IN URINARY STONE

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg47pJLfI7L2WBVOR8p8vhx4qoJzqGhHL_ZS65FiJEF3MIp0Jwft68cTyneiTr8LCx2nUtVjTKNGoqMVcfCR8P7BTvkI5PWYqX11Wlm5th46p3bPgCBEE9kOIsrgVPsLW8Vnucn93F37cQ/s1600/Lumenis-640x400.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="400" data-original-width="640" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg47pJLfI7L2WBVOR8p8vhx4qoJzqGhHL_ZS65FiJEF3MIp0Jwft68cTyneiTr8LCx2nUtVjTKNGoqMVcfCR8P7BTvkI5PWYqX11Wlm5th46p3bPgCBEE9kOIsrgVPsLW8Vnucn93F37cQ/s320/Lumenis-640x400.jpg" width="320" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiVUS1JHTIfr_y5tNCSio1UUxRnQ6NGYAo6HcvWoNP6A6xJIWHnv98-nP6j3fFM2apEFatb5QmNqCqt-6zVmSmqwFH8HAaThjZvLfBmWw1kZuyvBKW6ts2V53vYUKpVTZvDMVH_8Rhbbc/s1600/Screen+Shot+2019-08-20+at+10.16.38+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="751" data-original-width="1363" height="176" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiVUS1JHTIfr_y5tNCSio1UUxRnQ6NGYAo6HcvWoNP6A6xJIWHnv98-nP6j3fFM2apEFatb5QmNqCqt-6zVmSmqwFH8HAaThjZvLfBmWw1kZuyvBKW6ts2V53vYUKpVTZvDMVH_8Rhbbc/s320/Screen+Shot+2019-08-20+at+10.16.38+PM.png" width="320" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <br /><a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/9UmwmwJV6uYqJ8%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/laser-techniques-for-urinary-stones" title="Laser Techniques for Urinary stones" target="_blank">Laser Techniques for Urinary stones</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/9UmwmwJV6uYqJ8" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> <div style="margin-bottom: 5px;"> <strong> <a href="https://www.slideshare.net/Ekoindra4/laser-techniques-for-urinary-stones" target="_blank" title="Laser Techniques for Urinary stones">Laser Techniques for Urinary stones</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div> </a><br /><br /> <br /><br />The holmium:yttriumaluminum- garnet (Ho:YAG) laser is the most widely used laser for URS, with modern systems providing users with a range of settings and parameters that have numerous effects on stone fragmentation

LASER TECHNIQUE IN URINARY STONE

Laser Techniques for Urinary stones from Eko indra The holmium:yttriumaluminum- garnet (Ho:YAG) laser is the most widely u...

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SIRS, SEPSIS, AND MODS

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1w-YoyFnnjTMKnr5KyKopfF4A1TzOSJ1F-Fu2gFlHGDByA4IrIOxAP6I97gUS_1_kWoODPwg09nxXtEOBmbGc2JKJWUs4cIpYZyTcPfP5AbtPR1-qJt3m_Dy_qkgRC4RTiAxw0aK3zoI/s1600/Screen+Shot+2019-04-17+at+8.42.14+AM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="727" data-original-width="1010" height="230" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1w-YoyFnnjTMKnr5KyKopfF4A1TzOSJ1F-Fu2gFlHGDByA4IrIOxAP6I97gUS_1_kWoODPwg09nxXtEOBmbGc2JKJWUs4cIpYZyTcPfP5AbtPR1-qJt3m_Dy_qkgRC4RTiAxw0aK3zoI/s320/Screen+Shot+2019-04-17+at+8.42.14+AM.png" width="320" /></a></div> <div style="direction: ltr; margin-bottom: 6.0pt; margin-left: 0in; margin-top: 5.28pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span></div> <div style="direction: ltr; margin-bottom: 6.0pt; margin-left: 0in; margin-top: 5.28pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span></div> <div style="direction: ltr; margin-bottom: 6.0pt; margin-left: 0in; margin-top: 5.28pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial" , "helvetica" , sans-serif;">SIRS is characterized (1992) by two or more of the following : </span></div> <div style="direction: ltr; margin-bottom: 6.0pt; margin-left: 0in; margin-top: 5.28pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial" , "helvetica" , sans-serif;">1. Temperature > 38 C or < 36 C.</span></div> <div style="direction: ltr; margin-bottom: 6pt; margin-left: 0in; margin-top: 5.28pt; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial" , "helvetica" , sans-serif;">2. Heart rate > 90/minute.</span></div> <div style="direction: ltr; margin-bottom: 6pt; margin-left: 0in; margin-top: 5.28pt; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial" , "helvetica" , sans-serif;">3. Respiratory rate > 30/minute, or PaCo2 < 32 mmHg.</span></div> <div style="direction: ltr; margin-bottom: 6.0pt; margin-left: 0in; margin-top: 5.28pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial" , "helvetica" , sans-serif;">4. WBC count > 12000/mm3, < 4000/mm3, or > 10% band forms</span><br /> <span style="font-family: "arial" , "helvetica" , sans-serif;"><br /></span> <span style="font-family: "arial" , "helvetica" , sans-serif;">Please read more in below slide...</span></div> <div style="direction: ltr; margin-bottom: 6.0pt; margin-left: 0in; margin-top: 5.28pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <br /></div> <div style="direction: ltr; margin-bottom: 6.0pt; margin-left: 0in; margin-top: 5.28pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> <a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/dabzDFMCssaswz%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/sepsis-sirs-mof-and-ards" title="SEPSIS, SIRS, MOF, AND ARDS" target="_blank">SEPSIS, SIRS, MOF, AND ARDS</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/dabzDFMCssaswz" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> </a><br /> <div style="margin-bottom: 5px;"> <a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/dabzDFMCssaswz%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/sepsis-sirs-mof-and-ards" title="SEPSIS, SIRS, MOF, AND ARDS" target="_blank">SEPSIS, SIRS, MOF, AND ARDS</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><strong> </strong></a><strong><a href="https://www.slideshare.net/Ekoindra4/sepsis-sirs-mof-and-ards" target="_blank" title="SEPSIS, SIRS, MOF, AND ARDS">SEPSIS, SIRS, MOF, AND ARDS</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> <br /> <br /> <br /> <br /> <br /> <br /></div> </div>

SIRS, SEPSIS, AND MODS

SIRS is characterized (1992) by two or more of the following : 1. Temperature > 38 C or < 36 C. 2. Heart rate > 90/minut...

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ANDROGEN DEPRIVATION THERAPY (ADT)

<div class="separator" style="clear: both; text-align: center;"> </div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxw-FlGWNzMc-5_kjJ9YsoFrIsxEuUVAleRKU4dA0cwNOrdBUVTiaZ3seZq5e_eY_ttOPG85y8DdHxrgpYmkpZ8vkSv1T1_DLUwmm-FpToZ_X4gA_Y8DbHXjfxk38lJkcQ-akjs9ZKCus/s1600/WhatsApp+Image+2019-01-06+at+16.26.42.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1024" data-original-width="742" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxw-FlGWNzMc-5_kjJ9YsoFrIsxEuUVAleRKU4dA0cwNOrdBUVTiaZ3seZq5e_eY_ttOPG85y8DdHxrgpYmkpZ8vkSv1T1_DLUwmm-FpToZ_X4gA_Y8DbHXjfxk38lJkcQ-akjs9ZKCus/s320/WhatsApp+Image+2019-01-06+at+16.26.42.PNG" width="231" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXcBZKovMMvYJ180TfkdTH_OHcr0WJIAOfZXS4ie8yG081hBujZaWoy3QJIVeBLzZXlbHjmvtTySy3Iin1HYHwiVo_-G1FfniHHOJLbUnEplFlMZAw-RZ_j6oJ1TOSm-zmTeaZ4pjOeJM/s1600/Screen+Shot+2019-01-06+at+4.26.10+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="720" data-original-width="1273" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXcBZKovMMvYJ180TfkdTH_OHcr0WJIAOfZXS4ie8yG081hBujZaWoy3QJIVeBLzZXlbHjmvtTySy3Iin1HYHwiVo_-G1FfniHHOJLbUnEplFlMZAw-RZ_j6oJ1TOSm-zmTeaZ4pjOeJM/s320/Screen+Shot+2019-01-06+at+4.26.10+PM.png" width="320" /></a></div> <br /> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwGFtHJZK7GhqV0llFZHM9nAt3t5EYza1rmWl7pPbjzkeCc-4kRgvmLpmQsa-WBnTNHumtnZyqKOjwuZTiQSnlh1Ecbya2YZAp2RxGKE0h1FVyXVvlq9aH9Xg4CYP3XJ5fO4OQT6h41Ik/s1600/WhatsApp+Image+2019-01-06+at+16.26.42.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="color: black;"></span></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: center;"> <!--StartFragment--> <!--EndFragment--></div> <span style="font-family: "georgia" , "times new roman" , serif;">Androgen deprivation therapy (ADT), also called androgen suppression therapy, is an antihormone therapy whose main use in treating prostate cancer...</span><br /> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/x9evI2NP34VLwR%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/androgen-deprivation-theraphy-on-prastate-ca" title="ANDROGEN DEPRIVATION THERAPHY ON PRASTATE CA" target="_blank">ANDROGEN DEPRIVATION THERAPHY ON PRASTATE CA</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><span style="color: black;"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/x9evI2NP34VLwR" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> </span></a><br /> <div style="margin-bottom: 5px;"> <a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/x9evI2NP34VLwR%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/androgen-deprivation-theraphy-on-prastate-ca" title="ANDROGEN DEPRIVATION THERAPHY ON PRASTATE CA" target="_blank">ANDROGEN DEPRIVATION THERAPHY ON PRASTATE CA</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><span style="color: black;"><strong> </strong></span></a><span style="color: black;"><strong><a href="https://www.slideshare.net/Ekoindra4/androgen-deprivation-theraphy-on-prastate-ca" target="_blank" title="ANDROGEN DEPRIVATION THERAPHY ON PRASTATE CA">ANDROGEN DEPRIVATION THERAPHY ON PRASTATE CA</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </span></div> <span style="color: black;"> </span>

ANDROGEN DEPRIVATION THERAPY (ADT)

Androgen deprivation therapy (ADT), also called androgen suppression therapy, is an antihormone therapy whose main use ...

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SUBCAPSULAR NEPHRECTOMY TIPS

<div style="text-align: center;"> </div> <div style="text-align: justify;"> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0bs7spKjvhwmlrB6Xf4f-tUoLCcIxA84fkNjV7Ku7v7jD9UgxjspTi9mlo59iyIDoio6C7H4rN-GMzKoOswrYkKzR-X6495ekVGE5tKaoEiJ9YgZHUSgJHy1AnATa6RMOxZjk-htts-0/s1600/WhatsApp+Image+2019-01-06+at+07.01.45%25281%2529.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="580" data-original-width="609" height="304" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0bs7spKjvhwmlrB6Xf4f-tUoLCcIxA84fkNjV7Ku7v7jD9UgxjspTi9mlo59iyIDoio6C7H4rN-GMzKoOswrYkKzR-X6495ekVGE5tKaoEiJ9YgZHUSgJHy1AnATa6RMOxZjk-htts-0/s320/WhatsApp+Image+2019-01-06+at+07.01.45%25281%2529.png" width="320" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: center;"> </div> <div class="separator" style="clear: both; text-align: center;"> </div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaZQE6G9TtKMmSLdWRW0y0qul2_bq7C4qsOJ80ZRYHAO2MKCYjVQQkKO6NBohkVv5ZKIhWCZhTnMMs_T623XBuKA0oEa_mZvYEObpapRovLfjOUjne5gMd-DlYaEDTzeij-Gipthc1jAQ/s1600/WhatsApp+Image+2019-01-06+at+07.01.45.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="649" data-original-width="591" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaZQE6G9TtKMmSLdWRW0y0qul2_bq7C4qsOJ80ZRYHAO2MKCYjVQQkKO6NBohkVv5ZKIhWCZhTnMMs_T623XBuKA0oEa_mZvYEObpapRovLfjOUjne5gMd-DlYaEDTzeij-Gipthc1jAQ/s320/WhatsApp+Image+2019-01-06+at+07.01.45.jpeg" width="291" /></a></div> <span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></div> <div style="text-align: justify;"> <div class="separator" style="clear: both; text-align: center;"> </div> <span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">Teknik nefrektomi ini dikerjakan apabila konvensional nefrektomi tidak dapat dikerjakan, semisal durante operasi kita menghadapi perlengketan ginjal dengan jaringan sekitar seperti lemak pararenal, intestine, liver, dll.</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">Tips Teknik Operasi  :</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Berdoa kepada Allah SWT dengan memohon pertolongan dan kemudahan  </span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Jika kita menghadapi perlengketan yang demikian menghambat untuk membebaskan ginjal, buka kapsul ginjal di daerah termudah dan teraman diantara perlengketan yg ada</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Telusuri kapsul dengan membebaskan ginjal yang ada dengan klem 90 (<i>right angle clamp</i>), ambil bagian dalam parenkim ginjal dibagian dlm kapsul dan potong/bakar menggunakan kauter. </span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Perluas pembebasan parenkim dengan cara yang sama hingga mencapai pedikel. </span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Gunakan teknik dua klem dan potong seperti approach pada nefrektomi tumor ginjal, hingga mencapai pedikel</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Jika mencurigai menemukan pembuluh darah besar, dapat dilakukan pengikatan dan pemotongan</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- setelah mencapai pedikel, atau kira-kira semua parenkim dpt diklem, gunakan teknik surginal knot, potong</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- jika mengalami kesulitan dalam mencapai pedikel, gunakan teknik jahit parenkim dengan teknik jelujur, kemudian angkat atau tarik ke distal, klem kembali dibagian proksimal dst hingga dpt mencapai pedikel, baru kemudian dilakukan klem pedikel dan CUT!</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Tempelkan surgisoft atau sejenisnya untuk membantu hemostasis, cukup ditempelkan atau jahit pada daerah yang aman.</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Peritoneum yang terbuka setelah kita masukkan air cucian maka tidak perlu dilakukan penutupan.</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;">- Operasi selesai, semoga bermanfaat.</span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></div> <div style="text-align: justify;"> <span style="font-family: "trebuchet ms" , sans-serif;"><br /></span></div> <div style="text-align: right;"> <span style="font-family: "trebuchet ms" , sans-serif;">Eko Indra, </span></div> <div style="text-align: right;"> <span style="font-family: "trebuchet ms" , sans-serif;">Medan, 6 Januari 2019</span></div> <br /> <br />

SUBCAPSULAR NEPHRECTOMY TIPS

Teknik nefrektomi ini dikerjakan apabila konvensional nefrektomi tidak dapat dikerjakan, semisal durante operasi kita men...

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Principles of Endourology

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEvXcumIINyybnAhmvWWpZv-QvXRnl4HfIuKDxDR7aKEmVW_DIsvgZRKfuYi5JPCu79Rq3_o-alfiEWynFrwLVNiAwN-UGqb55uLWeec4LQTkMDWWVJgp39KDjejqMT7c-3zWOMjPPjV8/s1600/Screen+Shot+2018-05-29+at+5.25.08+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="205" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEvXcumIINyybnAhmvWWpZv-QvXRnl4HfIuKDxDR7aKEmVW_DIsvgZRKfuYi5JPCu79Rq3_o-alfiEWynFrwLVNiAwN-UGqb55uLWeec4LQTkMDWWVJgp39KDjejqMT7c-3zWOMjPPjV8/s400/Screen+Shot+2018-05-29+at+5.25.08+PM.png" width="400" /></a></div> <span style="font-family: "calibri light"; font-weight: bold;"></span><span style="font-family: "calibri light"; font-weight: bold;"><br /></span> <span style="font-family: "calibri light"; font-size: large; font-weight: bold;">CYSTOURETHROSCOPY</span><!--EndFragment-->  <br /> <div style="direction: ltr; line-height: 90%; margin-bottom: 0pt; margin-left: .25in; margin-top: 10.0pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: -.25in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial"; mso-special-format: bullet;">•<span style="font-size: large;"> </span></span><span style="font-size: large;"><span style="color: black; font-family: "calibri";">Provides direct visualization of the </span><span style="color: black; font-family: "calibri";">anterior </span><span style="color: black; font-family: "mangal";">–</span><span style="color: black; font-family: "calibri";"> posterior urethra </span><span style="color: black; font-family: "calibri";">and bladder</span></span></div> <div style="direction: ltr; line-height: 90%; margin-bottom: 0pt; margin-left: .25in; margin-top: 10.0pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: -.25in; unicode-bidi: embed; word-break: normal;"> <span style="font-size: large;"><span style="font-family: "arial"; mso-special-format: bullet;">• </span><span style="color: black; font-family: "calibri";">Rigid or flexible</span></span></div> <div style="direction: ltr; line-height: 90%; margin-bottom: 0pt; margin-left: .25in; margin-top: 10.0pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: -.25in; unicode-bidi: embed; word-break: normal;"> <span style="font-size: large;"><span style="font-family: "arial"; mso-special-format: bullet;">• </span><span style="color: black; font-family: "calibri";">Rigid provides larger </span><span style="color: black; font-family: "calibri";">workshing</span><span style="color: black; font-family: "calibri";"> channels, easier to control, and better visualization...</span></span><br /> <span style="color: black; font-family: "calibri";"><br /></span> <span style="color: black; font-family: "calibri";"><br /></span> <span style="color: black; font-family: "calibri";"><a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/1F0miL8dIpG3Sw%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/principles-of-endourology" title="Principles of Endourology" target="_blank">Principles of Endourology</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/1F0miL8dIpG3Sw" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> </a></span><br /> <div style="margin-bottom: 5px;"> <span style="color: black; font-family: "calibri";"><a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/1F0miL8dIpG3Sw%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/principles-of-endourology" title="Principles of Endourology" target="_blank">Principles of Endourology</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><strong> </strong></a><strong><a href="https://www.slideshare.net/Ekoindra4/principles-of-endourology" target="_blank" title="Principles of Endourology">Principles of Endourology</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </span></div> <span style="color: black; font-family: "calibri";"> </span> <br /> <br /> <br /> <br /> <br /> <br /> <br /></div>

Principles of Endourology

CYSTOURETHROSCOPY   •   Provides direct visualization of the anterior – posterior urethra and bladder •  Rigid or flexible • Rigid...

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BLADDER CAPACITY

<span style="color: black;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWzuG-qEV2GRa1eg8FmAFEot3jzUySBFWyQC08vPUFzcY2qFk590vY57OlUReasP4vqCtNtQjxmb0d7Iuq4ZRHVOqeYCMhVVaKj2oUFF7v1kgcuCELQJ09DfcUhu85dy2YoItR8AxrtX4/s1600/Screen+Shot+2018-05-29+at+5.50.42+PM.png" imageanchor="1"><img border="0" height="443" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWzuG-qEV2GRa1eg8FmAFEot3jzUySBFWyQC08vPUFzcY2qFk590vY57OlUReasP4vqCtNtQjxmb0d7Iuq4ZRHVOqeYCMhVVaKj2oUFF7v1kgcuCELQJ09DfcUhu85dy2YoItR8AxrtX4/s640/Screen+Shot+2018-05-29+at+5.50.42+PM.png" width="640" /></a></span><br /> <div class="O0" style="direction: ltr; margin-bottom: 0pt; margin-left: .3in; margin-top: 0pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: -.3in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: "arial rounded mt bold";"><br /></span></div> <div style="direction: ltr; margin-bottom: 0pt; margin-left: 0in; margin-top: 5.2pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;"> </div> <br /> <ul> <li><span style="font-family: "arial rounded mt bold"; text-indent: -0.3in;">Koff</span><span style="font-family: "arial rounded mt bold"; text-indent: -0.3in;"> formula (bladder capacity [in ounces]: </span><span style="font-family: "arial rounded mt bold"; text-indent: 0in;">(Age </span><span style="font-family: "arial rounded mt bold"; text-indent: 0in;">(in years) + 2) × 30</span></li> <li><span style="font-family: "arial rounded mt bold";">The ABC formula  : </span><span style="font-family: "arial rounded mt bold";">(Age (A) x 30) / 2</span></li> <li><span style="font-family: "arial rounded mt bold"; text-indent: -0.38in;">Daniel Costa et al : </span><span style="font-family: "arial rounded mt bold"; text-indent: 0in;"> </span><span style="font-family: "arial rounded mt bold"; text-indent: 0in;">[1.6 × age (months) + 45]</span></li> <li><span style="font-family: "arial rounded mt bold"; text-indent: -0.38in;">Fairhurst</span><span style="font-family: "arial rounded mt bold"; text-indent: -0.38in;"> formula  : </span><span style="font-family: "arial rounded mt bold"; text-indent: 0in;">[7 × weight (kg)] </span><span style="font-family: "arial rounded mt bold"; text-indent: 0in;">which gives a bladder capacity estimate in </span><span style="font-family: "arial rounded mt bold"; text-indent: 0in;">millilitres</span></li> </ul> <div> <span style="font-family: "arial rounded mt bold";"><br /></span></div> <div> <span style="font-family: "arial rounded mt bold";"><a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/9h7VLvc3VYC9N6%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/bladder-capacity" title="Bladder Capacity " target="_blank">Bladder Capacity </a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/9h7VLvc3VYC9N6" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> </a></span><br /> <div style="margin-bottom: 5px;"> <span style="font-family: "arial rounded mt bold";"><a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/9h7VLvc3VYC9N6%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/bladder-capacity" title="Bladder Capacity " target="_blank">Bladder Capacity </a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><strong> </strong></a><strong><a href="https://www.slideshare.net/Ekoindra4/bladder-capacity" target="_blank" title="Bladder Capacity ">Bladder Capacity </a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </span></div> <span style="font-family: "arial rounded mt bold";"> </span></div>

BLADDER CAPACITY

Koff formula (bladder capacity [in ounces]:  (Age (in years) + 2) × 30 The ABC formula  :  (Age (A) x 30) / 2 Daniel Costa et al :...

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Trabekulasi

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbFoE3XZp9F-ABphI-g3CzHPJxRnDsulB7BiDOSpTLTMoWBNW3K2WClPr2fz2XqPrUQpTMlDv4aPm9atIB-9EzkaKXiZFiryrL7KB9fSNwVX1d94ceCX6BLxU6ZOIpRdm1ACRdFFrg6cc/s1600/bladder-trabeculation.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="326" data-original-width="400" height="162" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbFoE3XZp9F-ABphI-g3CzHPJxRnDsulB7BiDOSpTLTMoWBNW3K2WClPr2fz2XqPrUQpTMlDv4aPm9atIB-9EzkaKXiZFiryrL7KB9fSNwVX1d94ceCX6BLxU6ZOIpRdm1ACRdFFrg6cc/s200/bladder-trabeculation.jpg" width="200" /></a></div> <br /> <br /> <br /> <div>  <br /> <br /> <br /> <br /> <br /> <br /> <br /> Grade 0 : No trabeculation<br /> <div> Grade 1 : <b><span style="font-family: 'Times New Roman'; font-size: 12pt; line-height: 17.1200008392334px;">≤</span></b>   5 mm </div> <div> Grade 2 : 5-10 mm </div> <div> Grade 3 : <b><span style="font-family: 'Times New Roman'; font-size: 12pt; line-height: 17.1200008392334px;">≥</span></b> 10 mm  </div> </div> <div> <br /></div>

Trabekulasi

  Grade 0 : No trabeculation Grade 1 :  ≤    5 mm  Grade 2 : 5-10 mm  Grade 3 :  ≥  10 mm  

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Urologic Ultrasonography

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_xp6U6jBMqpM5CAuNjCyCHBNBoG92aSZ6DNxZQwVHElN9N-rRveO_fULwdUkViJ0YDFyOJE60gOadAfwd8KFvSmoRSX8-8ZnwIWSfDTTfrjdeooxM6k_iIjMi3PcMtedy1Ubn_FuIGjQ/s1600/Screen+Shot+2018-03-19+at+11.24.47+PM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="color: black;"><img border="0" data-original-height="719" data-original-width="1021" height="225" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_xp6U6jBMqpM5CAuNjCyCHBNBoG92aSZ6DNxZQwVHElN9N-rRveO_fULwdUkViJ0YDFyOJE60gOadAfwd8KFvSmoRSX8-8ZnwIWSfDTTfrjdeooxM6k_iIjMi3PcMtedy1Ubn_FuIGjQ/s320/Screen+Shot+2018-03-19+at+11.24.47+PM.png" width="320" /></span></a></div> <br /> <span style="font-family: "calibri"; text-indent: -0.38in;"><br /></span> <br /> <div style="direction: ltr; margin-bottom: 0pt; margin-left: .38in; margin-top: 6.0pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: -.38in; unicode-bidi: embed; word-break: normal;"> <ul> <li><span style="font-family: "calibri"; text-indent: -0.38in;">Interaction of soundwaves w/ tissues and structures within the human body </span><span style="font-family: "wingdings"; text-indent: -0.38in;">à</span><span style="font-family: "calibri"; text-indent: -0.38in;"> ultrasound imaging</span></li> <li><span style="font-family: "calibri"; text-align: justify; text-indent: -0.38in;">The soundwaves are longitudinal waves </span><span style="font-family: "wingdings"; text-align: justify; text-indent: -0.38in;">à</span><span style="font-family: "calibri"; text-align: justify; text-indent: -0.38in;"> the particle motion is in the same direction as the propagation of the wave. </span><span style="font-family: "calibri"; text-align: justify; text-indent: -0.38in;">The transducer = a receiver for the returning sound wave reconverting the mechanical wave to </span><span style="font-family: "calibri"; text-align: justify; text-indent: -0.38in;">electrical energy</span></li> </ul> </div> <!--StartFragment--> <!--EndFragment--><br /> <br /> <br /> <a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/FMloJI7n2OZL0U%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/urologic-ultrasonography-91178538" title="Urologic Ultrasonography" target="_blank">Urologic Ultrasonography</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><span style="color: black;"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/FMloJI7n2OZL0U" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> </span></a><br /> <div style="margin-bottom: 5px;"> <span style="color: black;"><a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/FMloJI7n2OZL0U%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/urologic-ultrasonography-91178538" title="Urologic Ultrasonography" target="_blank">Urologic Ultrasonography</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"> </a><a href="https://www.slideshare.net/Ekoindra4/urologic-ultrasonography-91178538" target="_blank" title="Urologic Ultrasonography">Urologic Ultrasonography</a> from <a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></span> </div>

Urologic Ultrasonography

Interaction of soundwaves w/ tissues and structures within the human body à ultrasound imaging The soundwaves are longitudinal wave...

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EXTENDED PYELONEPHROLITHOTOMY

<br /> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWZbjvj0TvWSMt9VgYQVG1xgOsU1huR-hRGo0vcI2XTAWkBXlvQPEcCbu6TxpmVMO-fXHmlnXZfE1hRBQVKa9mOjvxpBFnJB5XjK3cE61N3UpJjnKNco8kaTcKgTyYJsZIONBluEbMemM/s1600/Screen+Shot+2018-06-02+at+6.40.21+AM.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="204" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWZbjvj0TvWSMt9VgYQVG1xgOsU1huR-hRGo0vcI2XTAWkBXlvQPEcCbu6TxpmVMO-fXHmlnXZfE1hRBQVKa9mOjvxpBFnJB5XjK3cE61N3UpJjnKNco8kaTcKgTyYJsZIONBluEbMemM/s320/Screen+Shot+2018-06-02+at+6.40.21+AM.png" width="320" /></a><br /> <br /> <br /> <br /> <a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/FhW08GUpzrJsH3%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/extended-pyelonephrolithotomy" title="EXTENDED PYELONEPHROLITHOTOMY" target="_blank">EXTENDED PYELONEPHROLITHOTOMY</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/FhW08GUpzrJsH3" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> </a><br /> <div style="margin-bottom: 5px;"> <a href="https://www.blogger.com/%3Ciframe%20src=%22//www.slideshare.net/slideshow/embed_code/key/FhW08GUpzrJsH3%22%20width=%22595%22%20height=%22485%22%20frameborder=%220%22%20marginwidth=%220%22%20marginheight=%220%22%20scrolling=%22no%22%20style=%22border:1px%20solid%20#CCC; border-width:1px; margin-bottom:5px; max-width: 100%;" allowfullscreen> </iframe> <div style="margin-bottom:5px"> <strong> <a href="//www.slideshare.net/Ekoindra4/extended-pyelonephrolithotomy" title="EXTENDED PYELONEPHROLITHOTOMY" target="_blank">EXTENDED PYELONEPHROLITHOTOMY</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>" target="_blank"><strong> </strong></a><strong><a href="https://www.slideshare.net/Ekoindra4/extended-pyelonephrolithotomy" target="_blank" title="EXTENDED PYELONEPHROLITHOTOMY">EXTENDED PYELONEPHROLITHOTOMY</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div> <br /> <br /> <br /> <br />

EXTENDED PYELONEPHROLITHOTOMY

EXTENDED PYELONEPHROLITHOTOMY from Eko indra

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OPEN URETEROLITHOTOMY

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdc-Xr43tk9zt6g23XDYJlJQKNRR8nYNqpVBKDAs4m4XZ5k3xSpUUiB5u6nmPqk3I39op1lV5nkla3F9ggsS_kkdTqiocBg0LH1XeTdv0qvTYPZkntUZv6MpOYDjA9DWHzbZMEbog4G8o/s1600/Screen+Shot+2018-01-14+at+9.46.25+AM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="711" data-original-width="1019" height="223" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdc-Xr43tk9zt6g23XDYJlJQKNRR8nYNqpVBKDAs4m4XZ5k3xSpUUiB5u6nmPqk3I39op1lV5nkla3F9ggsS_kkdTqiocBg0LH1XeTdv0qvTYPZkntUZv6MpOYDjA9DWHzbZMEbog4G8o/s320/Screen+Shot+2018-01-14+at+9.46.25+AM.png" width="320" /></a></div> <div style="direction: ltr; line-height: normal; margin-bottom: 0pt; margin-left: .38in; margin-right: 0in; margin-top: 5.0pt; text-align: left; text-indent: -.38in; unicode-bidi: embed; word-break: normal;"> <span style="font-size: 24.0pt;"><span style="font-family: Arial; font-size: 100%; mso-special-format: bullet;"><br /></span></span></div> <div style="direction: ltr; line-height: normal; margin-bottom: 0pt; margin-left: .38in; margin-right: 0in; margin-top: 5.0pt; text-align: left; text-indent: -.38in; unicode-bidi: embed; word-break: normal;"> <!--StartFragment--><span style="color: #2f5897; font-family: 'Palatino Linotype'; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; letter-spacing: 0pt; vertical-align: baseline;">Indication :</span><!--EndFragment--></div> <div style="direction: ltr; line-height: normal; margin-bottom: 0pt; margin-left: .38in; margin-right: 0in; margin-top: 5.0pt; text-align: left; text-indent: -.38in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: Arial;">•</span><span style="color: black; font-family: 'Century Gothic'; font-style: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; font-weight: normal; letter-spacing: 0pt; text-transform: none; vertical-align: baseline;">Stones with a low likelihood of treatment success using </span><span style="color: black; font-family: 'Century Gothic'; font-style: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; font-weight: normal; letter-spacing: 0pt; text-transform: none; vertical-align: baseline;">ESWL</span><span style="color: black; font-family: 'Century Gothic'; font-style: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; font-weight: normal; letter-spacing: 0pt; text-transform: none; vertical-align: baseline;"> &</span><span style="color: black; font-family: 'Century Gothic'; font-style: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; font-weight: normal; letter-spacing: 0pt; text-transform: none; vertical-align: baseline;"> URS</span></div> <div style="direction: ltr; line-height: normal; margin-bottom: 0pt; margin-left: .38in; margin-right: 0in; margin-top: 5.0pt; text-align: left; text-indent: -.38in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: Arial;">•</span><span style="color: black; font-family: 'Century Gothic'; font-style: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; font-weight: normal; letter-spacing: 0pt; text-transform: none; vertical-align: baseline;">Secondary treatment for treatment failure after less invasive </span><span style="color: black; font-family: 'Century Gothic'; font-style: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; font-weight: normal; letter-spacing: 0pt; text-transform: none; vertical-align: baseline;">techniques</span></div> <!--StartFragment--> <!--EndFragment--><br /> <div style="direction: ltr; line-height: normal; margin-bottom: 0pt; margin-left: .38in; margin-right: 0in; margin-top: 5.0pt; text-align: left; text-indent: -.38in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: Arial;">•</span><span style="color: black; font-family: 'Century Gothic'; font-style: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; font-weight: normal; letter-spacing: 0pt; text-transform: none; vertical-align: baseline;">Developing countries without access to URS or lithotripsy </span><span style="color: black; font-family: 'Century Gothic'; font-style: normal; font-variant-caps: normal; font-variant-east-asian: normal; font-variant-ligatures: normal; font-variant-position: normal; font-weight: normal; letter-spacing: 0pt; text-transform: none; vertical-align: baseline;">equipment</span></div> <br /> <br /> <br /> <br /> <a href="http://[slideshare%20id%3D83715082%26doc%3Dteknikoperasiopenuretereko-171209110135]/" target="_blank"><iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/AD8GyWEqChlxko" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> </a><br /> <div style="margin-bottom: 5px;"> <a href="http://[slideshare%20id%3D83715082%26doc%3Dteknikoperasiopenuretereko-171209110135]/" target="_blank"><strong> </strong></a><strong><a href="https://www.slideshare.net/Ekoindra4/open-ureterolithotomy" target="_blank" title="Open Ureterolithotomy">Open Ureterolithotomy</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div>

OPEN URETEROLITHOTOMY

Indication : • Stones with a low likelihood of treatment success using ESWL & URS • Secondary treatment for treatment fa...

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Angiomyolipoma

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEji0g1jcnWi9YFuNajdzinvbHNfiuk362k0JqIXf6F_LPr779at1S5NhqQduCBfo-JDhzk2B-ww1TwB9A4Q03UeSBmcxK-87cyQotgGoE5zlNqh4N6aNK6g5GWaCLM0_jjt8mkPGk_W7S4/s1600/Screen+Shot+2017-05-31+at+8.46.11+AM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="768" data-original-width="1366" height="179" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEji0g1jcnWi9YFuNajdzinvbHNfiuk362k0JqIXf6F_LPr779at1S5NhqQduCBfo-JDhzk2B-ww1TwB9A4Q03UeSBmcxK-87cyQotgGoE5zlNqh4N6aNK6g5GWaCLM0_jjt8mkPGk_W7S4/s320/Screen+Shot+2017-05-31+at+8.46.11+AM.png" width="320" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: left;"> <br /></div> <div style="direction: ltr; margin-bottom: 0pt; margin-left: .38in; margin-top: 7.68pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: -.38in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: Calibri; text-indent: -0.38in;"><br /></span></div> <div style="direction: ltr; margin-bottom: 0pt; margin-left: .38in; margin-top: 7.68pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: -.38in; unicode-bidi: embed; word-break: normal;"> <span style="font-family: Calibri; text-indent: -0.38in;"><b>Introduction</b></span></div> - 10% of renal tumors<br />- with autopsy series and ultrasound-screened populations showing a 0.3% and 0.13%<br />   incidence in the general population (Eble, 1998).<br /><br /> <br /><br /><br /><div> <br /></div> <div> <iframe allowfullscreen="" frameborder="0" height="485" marginheight="0" marginwidth="0" scrolling="no" src="//www.slideshare.net/slideshow/embed_code/key/t2FniE31Iers8W" style="border-width: 1px; border: 1px solid #CCC; margin-bottom: 5px; max-width: 100%;" width="595"> </iframe> <br /> <div style="margin-bottom: 5px;"> <strong> <a href="https://www.slideshare.net/Ekoindra4/angiomyolipoma-76506029" target="_blank" title="Angiomyolipoma">Angiomyolipoma</a> </strong> from <strong><a href="https://www.slideshare.net/Ekoindra4" target="_blank">Eko indra</a></strong> </div> </div>

Angiomyolipoma

Introduction - 10% of renal tumors - with autopsy series and ultrasound-screened populations showing a 0.3% and 0.13%    incidence...

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LITHOTRIPTOR

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYrma9BBqMtqEX6Ge-vjqFu_9aYOVVvY_LOC5CuK_WqCnXeFp5Y1Q-tvuasdYSAaJip4E9f0k1hbmOB6or_rGjQTwFRYUqNCM8K1jjCjzgTJyXY4TDjuEZzvlkG_d8XtHwK5fSIHJGpmY/s1600/713_main.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="432" data-original-width="700" height="197" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYrma9BBqMtqEX6Ge-vjqFu_9aYOVVvY_LOC5CuK_WqCnXeFp5Y1Q-tvuasdYSAaJip4E9f0k1hbmOB6or_rGjQTwFRYUqNCM8K1jjCjzgTJyXY4TDjuEZzvlkG_d8XtHwK5fSIHJGpmY/s320/713_main.jpg" width="320" /></a></div> <br /> <br /> <div class="MsoNormal" style="line-height: 150%;"> <span style="line-height: 150%;">LITHOTRIPTOR  :<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="line-height: 150%;"><span style="mso-list: Ignore;">1   1. </span></span><span style="line-height: 150%;">Intracorporeal<span style="mso-spacerun: yes;">  </span>: </span><span style="line-height: 150%; text-indent: -18pt;">A.<span style="font-family: "times new roman"; line-height: normal;">   </span></span><span style="line-height: 150%; text-indent: -18pt;">Flexible  :  - Electrohydraulic</span></div> <div class="MsoNormal" style="line-height: 150%; margin-left: 108.0pt;"> <span style="line-height: 150%;"><span style="mso-spacerun: yes;">                   </span>- Laser <span style="mso-spacerun: yes;">  </span><o:p></o:p></span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-left: 54.0pt; mso-add-space: auto; mso-list: l1 level1 lfo2; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="line-height: 150%;"><span style="mso-list: Ignore;">                  B.<span style="font-family: "times new roman"; font-style: normal; font-weight: normal; line-height: normal;">   </span></span></span><!--[endif]--><span style="line-height: 150%;">Rigid<span style="mso-spacerun: yes;">       </span>:<span style="mso-spacerun: yes;">  </span>- Ballistic <o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 150%; margin-left: 72.0pt; text-indent: 36.0pt;"> <span style="line-height: 150%;"><span style="mso-spacerun: yes;">                    </span>- Ultrasonic <o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 162.0pt; mso-add-space: auto;"> <br /></div> <!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--> <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> 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150%;"><span style="mso-list: Ignore;">2    2. </span></span><span style="line-height: 150%;">Extracorporeal (ESWL)<span style="font-size: 16pt;"><o:p></o:p></span></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;">b</span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"> <span style="line-height: 150%;"><br /></span></div>

LITHOTRIPTOR

LITHOTRIPTOR  : 1   1. Intracorporeal   :  A.    Flexible  :  - Electrohydraulic                     - Laser                     ...

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Kapasitas Buli

<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjyyVukLKDe0T1hDqcXnbfNOjZOcQ3Vy4-_E_OlzDh4w56iTKR2pRldjvgFuGHYuRzTME5TJjOH8_492RmyMjBBSon1_l7y3vBM5KMK7ccZZvM16fybUSzMtfdwV_6WArcUtFXRKS5xfHU/s1600/notes.jpg" imageanchor="1"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjyyVukLKDe0T1hDqcXnbfNOjZOcQ3Vy4-_E_OlzDh4w56iTKR2pRldjvgFuGHYuRzTME5TJjOH8_492RmyMjBBSon1_l7y3vBM5KMK7ccZZvM16fybUSzMtfdwV_6WArcUtFXRKS5xfHU/s400/notes.jpg" /></a><br /> <br /> Kapasitas buli anak :<br /> <div> 3 x (Umur+2) cc</div>

Kapasitas Buli

Kapasitas buli anak : 3 x (Umur+2) cc

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Cara ukur tekanan intra buli

<div> <span style="font-family: "helvetica neue light" , , "helvetica" , "arial" , sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwRviKJPmSlE4u5-KuSsMRWRVUSkVGV5pkWpQ92buCTPN1tdhe2_o1anx7roZ1Xy0XhYV1_SRPOlpHhI1AnRm9Q-Vx1hdi7TYtaobRQWYSTRu3SvYDbrSXtYaQWxDMYnLp_ohXnetT0FU/s1600/tmp25344.jpg" imageanchor="1"><img border="0" height="175" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwRviKJPmSlE4u5-KuSsMRWRVUSkVGV5pkWpQ92buCTPN1tdhe2_o1anx7roZ1Xy0XhYV1_SRPOlpHhI1AnRm9Q-Vx1hdi7TYtaobRQWYSTRu3SvYDbrSXtYaQWxDMYnLp_ohXnetT0FU/s320/tmp25344.jpg" width="320" /></a></span><br /> <span style="font-family: "helvetica neue light" , , "helvetica" , "arial" , sans-serif;"><br /></span> Berikut cara sederhana mengukur tekanan intra buli (Bladder pressure)  :<br /> <br /> <ul> <li>Masukkan Nacl 50 ml menggunakan Spuit 50 ml ke dalam buli, </li> <li>Posisikan kateter sejajar dengan MUE, kemudian naikkan catheter Tegak lurus mengikuti manometer (bisa juga gunakan penggaris jika tidak tersedia manometer)</li> <li>Ukur kenaikan air berapa cmH2O </li> <li>Konversikan ke mmHg (x 0,7)</li> </ul> <div> Interpretasi </div> <ul> <li>Normal 0-5 mmHg</li> <li>Abdominal hipertensi 10-15 mmHg</li> <li>Abdominal kompartemen 15-25 mmHg</li> </ul> <br /></div> <div> <div id="__p3" style="font-family: 'Times New Roman', stixgeneral, serif; font-size: 16px; line-height: 21px; margin-bottom: 0.6923em; margin-top: 0.6923em;"> The normal intra-abdominal pressure ranges between 0 and 5 mmHg. When it is mildly increased to between 10 and 15 mmHg, cardiac index is usually maintained or even increased because abdominal viscera are mildly squeezed and venous return increases. Respiratory and renal symptoms are unlikely to occur. Hepatosplanchnic blood flow may decrease [<a aria-expanded="false" aria-haspopup="true" class=" bibr popnode tag_hotlink tag_tooltip" href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC137242/#B5" id="__tag_97072382" rid="B5" role="button" style="color: #642a8f;">5</a>]. At this point, intravascular volume optimization will probably correct these alterations. When intra-abdominal pressure is moderately increased to between 15 and 25 mmHg the full syndrome may be observed, but usually responds to aggressive fluid resuscitation, and surgical decompression should be considered. At high pressures (< 25 mmHg) surgical decompression associated with fluid resuscitation and transient use of vasoconstrictive agents is mandatory. When surgical decompression is not feasible, application of a negative abdominal pressure should be considered [<a aria-expanded="false" aria-haspopup="true" class=" bibr popnode tag_hotlink tag_tooltip" href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC137242/#B6" id="__tag_97072377" rid="B6" role="button" style="color: #642a8f;">6</a>,<a aria-expanded="false" aria-haspopup="true" class=" bibr popnode tag_hotlink tag_tooltip" href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC137242/#B7" id="__tag_97072384" rid="B7" role="button" style="color: #642a8f;">7</a>].</div> </div> <div> Take from : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC137242/</div> <div> Illustration Image :http://www.ncbi.nlm.nih.gov/pmc/articles/PMC137242/</div> <div> <br /></div> <div> <br /></div>

Cara ukur tekanan intra buli

Berikut cara sederhana mengukur tekanan intra buli (Bladder pressure)  : Masukkan Nacl 50 ml menggunakan Spuit 50 ml ke dalam buli,  ...

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