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"Indonesia telah mengadopsi tingkat panduan dosis yang direkomendasikan oleh IAEA BSS 115 untuk beberapa jenis pemeriksaan sejak 2003. Pengukuran dosis masuk permukaan (entrance surface dose /ESD) untuk kepala dan cervical spine dengan menggunakan TLD dilakukan atas 4 pesawat sinar-X pada 3 rumah sakit di Jakarta yang diberi kode 1D, 1F, 1H dan 3H dengan reseptor sistem Kodak CR (computed radiography). Pengukuran ESD juga dilakukan berdasarkan parameter eksposinya menggunakan metode kalkulasi. Juga dilakukan pengukuran ESD pada fantom kepala ANSI dengan tujuan untuk mendapatkan faktor konversi fantom-pasien yang akan berguna dalam pengumpulan data ESD tanpa pasien. Pelaksanaan penelitian dimulai dari penentuan ukuran standar orang dewasa Indonesia, uji fungsi pesawat sinar-X, preparasi TLD, pengambilan data ESD pasien dan diakhiri dengan pembuatan dan verifikasi fantom kepala ANSI. Sebanyak 20 orang pasien dewasa menjalani pemeriksaan kepala dengan 2 atau 3 proyeksi (AP/PA, lateral dan waters), dan 17 pasien dewasa menjalani pemeriksaan cervical spine dengan 2 proyeksi (AP dan lateral). Pengukuran ESD dengan TLD dengan cara menempatkan TLD pada kulit pasien pada pusat lapangan radiasi. Dari pengukuran ESD menggunakan TLD pada pasien didapatkan nilai ESD pada kuartil ke-3 sebesar 1.4 mGy mGy, 1.4 mGy, dan 2.1 mGy untuk pemeriksaan kepala AP/PA, lateral, dan waters, serta 1.3 mGy dan 1.4 mGy untuk pemeriksaan cervical spine AP dan lateral. Sedangkan dari metode kalkulasi didapatkan nilai yang lebih tinggi, yaitu 2.7 mGy, 1.8 mGy dan 5.2 mGy untuk pemeriksaan kepala AP/PA, lateral, dan waters, serta 1.5 mGy for AP and 2.3 mGy untuk pemeriksaan cervical spine AP dan lateral. Rasio antara ESD pasien dengan fantom yang disebut faktor konversi fantom didapatkan sebesar 0.64 dan 0.77 untuk skull AP/PA dan lateral. Dalam penelitian ini, nilai ESD lebih dipengaruhi oleh kebiasaan radiografer dalam penentuan faktor eksposi yang akan digunakan. Meski demikian, nilai ESD yang didapatkan cenderung lebih kecil daripada nilai referensi yang ada. Selain itu penggunaan fantom kepala ANSI akan sangat bermanfaat dalam pengumpulan data ESD mengingat jumlah pemeriksaan kepala cukup jarang.

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Indonesia has adopted radiation dose guidance levels recommended by IAEA BSS 115 for several diagnostic examinations since 2003. Measurements of entrance surface dose (ESD) for head and cervical spine using TLD (thermo luminescence dosimeter) were carried out with 4 X-ray machines at 3 hospitals in Jakarta which were coded by 1D, 1F, 1H and 3H with Kodak CR (computed radiography) receptor system. Based on exposure, ESD for these examinations were also determined. ESD measurements were also conducted on ANSI skull phantom aiming to get conversion factors of phantom to patient that will be useful in collecting ESD data without patients.

This study began with determining Indonesian adult standard size, following by X-ray machine performance test, TLDs preparation, patient ESD measurement and ended with making ANSI skull phantom and ESD verification. There 20 adult patients for head examination with 2 or 3 radiography projections (AP/PA, lateral and waters), and 17 adult patients for cervical examination. The ESD was measured by TLD (thermo lunminiscence dosimeter), placed on the patient's skin, at the center of radiation field.

From the patient's ESD measurement using TLDs, the 3rd quartile ESD values were 1.4 mGy mGy, 1.4 mGy, and 2.1 mGy for head examination of AP/PA, lateral, and waters, while for AP and lateral cervical spine were 1.3 mGy and 1.4 mGy. Whereas ESD values from the calculation method based on exposure were higher, i.e. AP/PA, lateral and waters head examinations were 2.7 mGy, 1.8 mGy, and 5.2 mGy respectively, and for AP and lateral cervical spine examination were 1.5 mGy for AP and 2.3 mGy. The ratio between patient ESD and phantom ESD, namely conversion factors, were 0.641 and 0.765 for AP/PA and lateral skull examination.

In this study, ESD values found were more affected by technical habit of the radiographer in setting the exposure condition. In spite of that fact, it was found that these ESD values were still lower than references. Besides that, the usage of inhouse ANSI skull phantom will be beneficial for collecting ESD data considering the low frequency of head examinations."

"Cedera servikal merupakan salah satu cedera tulang belakang terbanyak pada pasien trauma. Di Amerika Serikat tahun2008 dari 100.000 kasus cedera tulang belakang, sebanyak 67% merupakan kasus cedera servikal. Penilaian awaldilakukan berdasarkan American Spinal Cord Injury Association (ASIA) impairment score namun prognosis outcomesering tidak diperhatikan. Tujuan penelitian untuk menganalisis nilai functional independence measure (FIM) pasiencedera servikal dengan manajemen konservatif dan korelasi dengan umur, jenis kelamin, jenis trauma, onset trauma,abnormalitas servikal, jenis lesi cervical spine, dan ASIA impairment score. Dilakukan studi kohor prospektif padasemua pasien cedera servikal yang memenuhi kriteria inklusi di bagian Bedah Saraf Rumah Sakit (RS) Dr. HasanSadikin Bandung. Subjek dikelompokkan berdasarkan umur, jenis kelamin, trauma tunggal/multipel, akut/kronik,abnormalitas servikal, lesi komplit/inkomplit dan ASIA impairment score. Pemeriksaan nilai FIM dilakukan diPoliklinik Bedah Saraf. Data dianalisis menggunakan uji t dan uji chi-kuadrat. Terdapat 17 pasien cedera servikal yangdirawat di bagian Bedah Saraf RS Dr. Hasan Sadikin Bandung periode April 2009?April 2010. Observasi kohorprospektif rata-rata nilai FIM pasien cedera servikal adalah 4±1,63. Analisis chi-kuadrat menyebutkan bahwa tidakterdapat hubungan umur, jenis kelamin, jenis trauma, onset trauma, abnormalitas servikal dengan besarnya nilai FIMpasien cedera servikal. Terdapat hubungan jenis lesi cervical spine, ASIA impairment score dengan besarnya nilai FIMpasien cedera servikal. Jenis lesi cervical spine dan ASIA impairment score memiliki hubungan bermakna denganbesarnya nilai FIM pasien 6 bulan pascacedera servikal.

Cervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000

spinal cord injury cases reported in the United States of America (2008), sixty seven percent involve cervical spine

injury. American Spinal Cord Injury Association (ASIA) impairment score is used as an initial assessment but not

enough attention prognostic outcome of these patients was paid to. The objective of this study is to analyze the value of

functional independence measure (FIM) cervical spine injury patients with conservative management and its correlation

with age, sex, type of trauma, onset of trauma, cervical abnormalities, type of cervical spine lesion and ASIA

impairment score. A prospective cohort study was performed to all patients with cervical spine injury treated in

Neurosurgery Department of Dr. Hasan Sadikin Hospital Bandung that fullfiled the inclusion criteria. The subjects were

classified based on age, sex, single/multiple trauma, acute/chronic, cervical abnormalities, complete/incomplete lesion

and ASIA impairment score. The FIM examination was performed in Outpatient clinic of Neurosurgery. T-test and chisquare

test was done to analyze the data. There were 17 cervical spine injury patients treated in Neurosurgery

Department of Dr. Hasan Sadikin Hospital during April 2009?April 2010. The average FIM value of cervical spine

injury in those patients is 4+1.63 by cohort prospective study. There were no correlation between FIM value with age,

sex, type of trauma, onset of trauma and cervical abnormalities. Significant correlations were found between FIM value

with type of cervical spine lesion and ASIA impairment score in cervical spine patients. Type of cervical spine lesion

and ASIA impairment score have significant correlation with FIM value of patients in 6 months after cervical injury."