_ Koran Bedah Saraf Sabtu 28 Maret 2015 Fix

KORAN BEDAH SARAF 20 MARET 2015

KORAN BEDAH SARAF 28 MARET 2015

LONTARA 3 BEDAH SARAF KAMAR 1

1K1B1

Dioni monjai

548947

21-11-1965

MRS :

26/2/2015Dr,dr djoko widodo Sp BSS : keluhan tidak adaO: Keadaan umum baik Tensi 150/90 mmHgGCS 15 (E4M6V5)

Pupil isokorA: intracranial tumorHipertensi heart diseaseTerapi sesuai TS kardiologiMonitor tensi /12jam

Rencana operasi menunggu jadwalLab 20/3/2015

Na: 144

K : 3,3

Cl : 100

Lab18/2/2015

PT/APTT 10,3/25,2

Ur/Cr 24/0,96

SGOT/SGPT 30/43

WBC 9,44

RBC 5,62

HGB 16,6

2K1B2

Muh. Alvin

689408

3-10-2014

MRS :

16/2/2015

Dr. dr. Nasrullah, Sp.BS S: Luka pada regio parietal semakin kering

Kepala membesar

O: kesan sakit sedang GCS 15(e4m6v5)

Region parietal bilateral

Luka parietal kiri: kering. Luka parietal kanan agak basahA: Hidrocephalus + ulkus decubitus region parietal bilateral-Cefixime syr cth/12j/oral

-Metronidazole syr 3/4cth/8j/oral

-Paracetamol syr 3/4cth /8j/iv

-Rawat luka dengan oxoferin /12 jamTerapi sesuai TS Pediatri

Lab 22-3-2015

Na: 140

K: 6.0

Cl: 110Lab 18/3/2015

WBC 12,1RBC 4.04HGB 11,0HCT 37PLT 489

GDS 88

Ur/Cr 16/0,21

SGOT 38

SGPT 32

Lab 15/3/2015

Na/K/Cl : 142/6,2/109


1K2B1

Aminsan

705070

18-5-2000MRS :17/3/2015Dr Andi Ihwan, Sp. BS S : gelisah berkurangO : KU baik.

GCS 15 (E4M6V5)

Pupil isokorA :TCS GCS 13 perbaikan GCS 15Maxillofacial injuryCefadroxil 500mg/12 jam/oralAsam mefenamat 500mg/8jam/oral

Ranitidine 150mg/8jam/oral

Neurodex 1 tablet/12jam/oral

Diet sesuai TS gizi klinik,ortopedi,bedah plastikLab 21/3/2015RBC 3.99

HGB 10.7

HCT 31.4

PLT 341

WBC 12,4

Protein total:7.4

Albumin 4.1

Lab 19/3/2015RBC 2,88

HGB 7,8

HCT 22,6

PLT 275

WBC 10,9

Na/Ka/Kl 141/4,4/110

Lab 17/3/2015

WBC 11,6

RBC 4,73HGB 12,8HCT 34,6

2.K2B2

Gaslar

702404

20-9-1974

MRS:

20/3/2015Dr,dr djoko widodo Sp BSS: visus menurunO:keadaan umum baik GCS 15 (E4M6V5)Pupil isokor

A:Intracranial tumorTunggu jadwal operasi

Rencana removal tumorLab 2/3/2015

RBC:4,54

HGB:14,7

HCT:42

PLT:218

WBC:6,3

GDS:148

Ur/Cr:16/0,90

SGOT/SGP:48/59Na/Ka/Kl 145/3,4/109


1K5B1

Salama

705565

2-10-1943

MRS

20-3-2014Dr. Andi Ihwan Sp BSS: nyeri kepala berkurangO: kesan sakit sedang GCS 14 (E3M6V5)

Pupil isokor 3mm/3mm

Luka telinga kiri kering

A: trauma capitis sedang GCS 11 perbaikan GCS 14

Subarachnoid hematom Fraktur linear os temporal sinistrahead up 30oringer laktat 28 tpm

ketorolac 30mg/8jam/iv

ranitidine 50mg/8jam/iv

piracetam 3gr/12jam/iv

mannitol 100cc/6jam/drips bila tensi > 100

diet biasaLab 20/3/2015

RBC: 3.45

HGB:10.6

HCT:31.9

PLT:182

WBC:13

GDS:140Ur/Cr:64/0,80

SGOT/SGP:67/47Na/Ka/Kl 141/4,1/108PT: 10.6APTT: 26

2K5B2

Agus satriya 703816

8-8-1982

MRS: 6-3-2015dr. Nasrullah, Sp.BSS : kesadaran menurunO: lemah GCS 13 (E4M5V4)Motorik

Menurun N

Menurun N

A: TCS GCS 10 dengan perbaikan GCS 13 cefadroxil 500mg/12jam/oralranitidine 150mg/12jam/oral

asam mefenamat 500mg/8jam/oral

neurodex 1tablet/12jam/oral

terapi lain sesuai T S Gizi klinik & mataLab (13-3-2015)

WBC: 11.5

RBC:3.58

HGB:10.8

PLT:382

Lab (10-3-2015)

Na: 145

K:4.5

Cl: 111

CT scan

Contusio cerebri region parietal kanan

Perdarahan subarachnoid region temporal kiri

Multihamatosinus DD/Multisinusitis

Soft tissue swelling region frontal sampai palpebra dextra

Pneumobulbi dextra

3K5B3

Abd.Halim

690039

01-05-1948

MRS:

14/3/2015

Dr. dr. Djoko Widodo Sp.BSPost cranioplasty hari IInfus ringer laktat 28 tpmCeftriaxone 1gr/12jam/ivRanitidine amp/8jam/iv

Ketorolac 1 ampul/8jam/iv

Takar drain/hari

Awasi KU dan tanda vitalLab 19/3/2015

GDS 110

WBC 5,7

RBC 4,94

HGB 13,9

HCT 44

PLT 146

SGOT 19

SGPT 10

Na/Ka/Kl 145/3,6/103

Ur/Cr 14/0,81

Lab 5/3/2015

PT/APTT 10,3/28,5

GDS 112

Ur/Cr 8/0,84

SGOT/SGPT 25/19

Albumin 4,4

WBC 7,26

RBC 5,46

HGB 15,5

PLT264

CT scan kepala 10-3-2015

Skull defect pada regio parietalis kiri

Ventriculomegaly

Encephalomalacia

Foto thorax 6-3-2015

Dilatatio elongatio et atherosclerosis aortae

4K5B4

Naruh

699446

23-09-1964

MRS :

21/2/2015

Dr willy adhimarta Sp BSS: luka region sacrumO: KU: Sakit sedang/Gizi cukup/SadarGCS 15 (E4M6V5)Motoric

5 5

2 2

Regio sacrum : luka semakin keringA: spinal cord injury

Ulkus decubitus region sacrum rencana laminoplasty

cefadroxil 500mg/12jam/oral metronidazole 500mg/8jam/oral

omeprazole 1 tablet/12jam/oral

asam mefenamat 500mg/8jam/oral

rawat luka dengan oxoferin

Lab 18/3/2015RBC : 4,54WBC : 9,6HGB : 12,5HCT : 41PLT : 419

GDS 62

SGOT 27

SGPT 20

Na/k/cl : 131/4.1/103

Lab tgl 9/3/2015SGOT/SGPT : 29/46

5.K5B5

Amiruddin

703996

28-7-1996

MRS :

17/3/2015De. Andi Ihwan, Sp.BSS: sakit kepala berkurangO: KU: Baik GCS 15

Pupil isokor

A: TCR GCS 15 maxillofacial Injury fraktur os mandibular sinistra cefadroxil 500mg/12jam/oral

Neurodex 1tablet/12jam/oral Ranitidin 50mg/8jam/IV

Cefadroxil 500mg/12jam/oral

Asam mefenamat 500mg/8jam/oral

Senmax 3x10 tetes via hidung kiri& kanan

Terapi sesua TS gizi klinik bedah plastikLab 19/3/2015

WBC 7,4

RBC 3,27

HGB 9,5

HCT 29

PLT 488

SGOT 42

SGPT 78

Lab 13/3/2015

RBC:3,08

HGB:9,7

HCT:28,4

WBC:6,6

6K5B6

Chairul Syam Hapil

702909

26-3-1990

MRS:

21/3/2015Dr. dr. Nasrullah, Sp.BSS: nyeri luka operasi berkurang

O: keadaan umum baik

GCS 15 (E4M6V5)

Regio kepala: tampak kasa penutup luka keringA:post cranioplasty hari IV ec skull defectRinger laktatCeftriaxone 1gr/12jam/iv

Ranitidine 1amp/8jam/iv

Ketorolac1amp/8jam/iv

Takar drain tiap hari

Lab 21/3/2015

WBC 7,4

RBC 4,51

HGB 14,7

HCT 42

PCT 0,3

GDS 95

Ur/Cr 18/0,80

SGOT 92

SGPT 143

Na/Ka/Kl 143/4,5/105

Lab 1/3/2015

Na/Ka/Kl 146/3,6/114

26-2-2015

B rain swelling

Hematoma subgaleal regio parietal sinistra

NOIDENTITASDPJPDIAGNOSISTINDAKANLABORATORIUM

LONTARA 3 BAWAH DEPAN KAMAR 3

1ISMAEL

16-11-2014

RM: 703889

MRS:dr. Andi Ihwan, Sp.BSS: Lemah, sesak

O: Sakit sedang/Menangis

A: Hidrocephalus + AnemiaRencana VP-Shunt

Terapi sesuai TS pediatric, subdivisi neurologis, respirologi, nutrisi metabolik

Optimalisasi KU

Bilas lambung???Laboratorium

25/03/2015RBC : 2.29

HGB : 6

HCT : 18.1

PLT : 345

WBC : 9.64

Ferritine : 299.18

Laboratorium

24-03-2015

Kultur dan sensitivitas urine

Sensitif:CeftazidimeChloramphenicolGentamicinNorfloxacinMeropenemLevofloxacinLaboratorium

23-03-20115

Mikrobiologi fesesKultur & sensitivitas Escherchia coli O157Kesan: Bakteri high pathogenicLaboratorium

19-03-2015

Mikrobiologi UrineKultur bahan lain/OAT : Tidak ada pertumbuhan bakteri aerob

2RESKI

11-07-1992

RM: 649241

MRS: 22-02-2015DR. dr. Nasrullah, Sp.BSS: Pusing berkurang

O: Sakit sedang, Pus (+)

A: Leakage CSF post cranioplasty + elevated liver enzymTunggu jadwal operasi

Metronidazole 500 mg/8 jam/oral

Ciprofloxacin 500 mg/12 jam/oral

Hp-Pro 3 dd 1 (H-10)

Kultur pus dari luka (tunggu hasil)Laboratorium

22/03/2015RBC : 5.58

HGB : 11.3

HCT : 35.8

PLT : 276

WBC : 9.7

PT : 10.8

APTT : 30.2

GDS : 113

Ureum/Cr : 14/0.6

SGOT /SGPT : 232/197

Na/K/Cl : 143/4.3/106

CT/BT : 7.00/2.00

Laboratorium :

14/3/2015SGOT /SGPT : 210/142

Laboratorium :

10/3/2015SGOT /SGPT : 209/125

Laboratorium :

07/3/2015SGOT /SGPT : 189/129

Laboratorium

04-03-2015Bilirubin total : 0.96

Bilirubin direk : 0.55

SGOT/SGPT : 225/156

Alkali fosfatase : 79

Gamma-GT : 83

Laboratorium

02-03-2015HBsAg : Reactive

Anti HCv : Non-reactive

USG abdomen

02-03-2015Tanda-tanda PID

Organ intraabdomen lainnya dalam batas normal

CT-scan kepala tanpa kontras:

17-02-2015Bone graft terpasang pada os temporoparietal sinistra disertai epidural hematoma, subgaleal hematoma, dan pneumocephal pada regio tersebut

Encephalomalacia regio frontotemporoparietal sinistra

3REZKIYANTI

18-08-1997

RM: 630827

MRS: 20-03-2015

Prof. DR. dr. Andi Asadul Islam, Sp.BSS: Tidak ada keluhan

O: Kesadaran baik GCS 15

A: Skull defectTunggu jadwal operasi Lapor OK

Konsul anastesi

Siap darah 2 bag PRC (1 ambil dan 1 siap)

Informed consent

Marking siteLaboratorium

16-03-2015

RBC : 8.2

HGB : 4.53

HCT : 39.5

PLT : 309

WBC : 8.2

PT : 10.9

APTT : 1.05

GDS : 130

Ureum/Cr : 10/0.59

SGOT /SGPT : 13/11

Na/K/Cl : 145/4.2/97

CT/BT : 8.00/3.00

Albumin: 4.4

CT-Scan kepala

17-03-2015

Kesan: Skull defect disertai encephalo malacia regio fronta dextra

Thoraks PA

Tidak tampak kelainan pada foto thoraks ini

4SYUAEBA PATAROI

24-04-1963

RM: 706144

MRS: 26-03-2015DR. dr. Nasrullah, Sp.BSS: Pusing

O: Sakit sedang, GCS 15, pupil isokor 4cm/4 cm. RC +/+

A: Trauma capitis ringan GCS 15IVFD RL 28 tpm

Ketorolac 30 mg/8 jam/IV

Ranitidin 50 mg/8 jam/IVNeurosanbe drip

Diet biasa

Laboratorium

WBC: 6.6RBC: 3.81HGB: 12.3HCT: 36PLT: 268CT/BT: 8.00/3.00GDS: 108Ur/Cr : 23/-SGOT/SGPT: 20/15Na/K/Cl: 141/3.3/108HBsAg: Non reactive

Anti HCV : Non-reacive


1

2HJ. HASIA

31-12-1959

RM: 705555

MRS: 20-03-2015Prof. Dr.dr>Andi Asadul Islam,Sp.BSS: Nyeri kepala

O: KU: Cukup /GCS 14 (E3M6V5), pupil isokor 4cm/4cm

RC +/+

A: Trauma capitis sedang

SAHIVFD RL 28 tpm

Ceftriaxone 1 gr/12 jam/I

Ketorolac 30 mg/8j jam/IV

Ranitidin 150 mg/8 jam/IV

Piracetam 3 gr/12 jam/oral

KJS Gizi klinik

Drips manitol 100 cc/8 jam/IV

Bila sistol 110 mmHg

Head up 30Laboratorium

22/03/2015

WBC: 12.7RBC: 3.88HGB: 11.5HCT: 35PLT: 384PT/APTT: 9.6/25.7

Laboratorium

20/03/2015WBC: 12.7RBC: 3.79HGB: 11.6HCT: 33.9PLT: 76GDS: 148Ur/Cr : 26/0.7SGOT/SGPT: 23/14Na/K/Cl: 143/4.2/110HBsAg: Non reactive

Anti HCV : Non-reaciveFoto thoraks

24-03-2015

Cardiomegaly dengan dilatatio, elongatio et atherosclerosis aortae

CT-Scan kepala

20-03-2015

Pendarahan subarachnoid Tanda-tanda brain swelling

3

4MASNY MADILIS

15-06-1987

RM: 703701

MRS: 16/03/2015dr. Nasrullah, Sp.BSS: Benjolan di kepala

O: Sakit sedang

Gizi baik

Composmentis

A: Kista epidermoidTunggu jadwal operasi

Cek lab ulangLaboratorium

25/03/2015

WBC: 6.0RBC: 5.08HGB: 13.5HCT: 39.3PLT: 301CT/BT: 7.30/3.00

PT/APTT: 10.3/24.8GDS: 104Ur/Cr : 19/0.60SGOT/SGPT: 17/12Na/K/Cl: 145/3.7/107HBsAg: Non reactive

Anti HCV : Non-reacivePA 06-03-2015

Kista epidermoid

Foto thoraks

Kesan:

Cor dan pulmo normal

Tidak ada tanda-tanda metastasis pada fot thoraks ini

CT-Scan 10 Oktober 2014

Kesan: Gambaran epidermoid cyst of the scalp

5

6NUR RIANA06-09-2009

RM: 705679

MRS: 23-03-2015dr. Willy Ahimarta,Sp.BSS: Nyeri kepala

O: Sakit sedang GCS 15

A: Post craniotomy POH-3

Fracture depress os frontalAff drain

Aff kateterAff infus

Cefadroxil syr 2x II cth

Paracetamol 3x II cthLaboratorium

23-03-2015

WBC: 15.36RBC: 4.15HGB: 11.5HCT: 32.9PLT: 286CT/BT:6.30/3GDS: 39Ur/Cr : 31/0.40SGOT/SGPT: 39/18Na/K/Cl: 137/4.2/110HBsAg: Non reactive

Anti HCV : Non-reaciveCT-Scan kepala

23-03-2015

Hematom intracerebri regio frontal dextra Depressed fractur sinistra disertai hematosinus ethmoidalis sinistra


1AGUSLAN

17-08-1998

RM: 705827

MRS: 23-03-2015dr. Willy Adhimarta, Sp.BSS: Nyeri kepala

O: KU: sakit sedang GCS 15

A: Trauma Capitis Ringan

Subgaleal hemoraghicIVFD RL 28 tpm

Ceftriaxone 1 gr/12 jam/IV

Ketorolac 30 mg/8 jam/IV


Diet biasaLaboratorium

23-03-2015

RBC : 3.75

WBC : 17.8

HGB : 11.5

HCT : 33.7

PLT:302CT/BT : 7.00/3.00

PT/APTT : 11.6/27.6

GDS : 139

Ur/Cr : 23/0.90

SGOT/SGPT : 34/22

Na/K/Cl : 140/3.7/107

HBsAg : Non-reactive

Anti HCV : Non-reactive

CT-Scan Kepala

24-03-2015

Brain window: Subgaleal hematom

Bone window: tidak ada

2MOHAMMAD ALIF

14/03/2014

RM: 705992

MRS: 24/03/2015Dr.dr.Nasrullah Mustam, Sp.BSS: Kepala pusing berkurang

O: Sakit sedang

Menangis kuat

Kepala membesar (+)

A: HydrocephalusTunggu jadwal operasi

Cek lab lengkap

Foto thoraks

CT-Scan kepalaLaboratorium

23/03/2015

WBC: 16.27

RBC: 5.35

HGB:

HCT:36.2

PLT: 513

PT/APTT: 13.1/26.8

Laboratorium

19/03/2015

WBC: 15.64

RBC: 4.80

HGB: 11.6

HCT:32.5

PLT: 468

PT/APTT: 13.1/26.8

Na/K/Cl : 140/49/110

CT/BT : 700/3.00


Anti HCV: Non-reactive

SGOT/SGPT : 37/16

GDS : 93

Ur/Cr: 11/0.4

CT-Scan kepala

03/02/2015

Hydrocephalus obstruktiff ec massa pada cerebellum

Foto thoraks

30-03-2015

Kesan: Tidak tampak kelainan pada foto thoraks ini

3MOHAMMAD RISKY MONY

30-06-2004

RM: 704143

MRS: 24/03/2015Dr.dr.Nasrullah, Sp. BSS: Kepala membesar dan nyeri

O: Sakit sedang/ kesadaran baik

A: Hydrocephalus

Massa regio ventrikel IIIP : VP- ShuntRencana VP-Shunt (tunggu jadwal)

Aff infuse .

Paracetamil 250 mg/ 8jam/ oralLaboratorium

12/03/2015

WBC: 5.87

RBC: 6.39

HGB: 34.9

HCT:48.5

PLT: 469

PT/APTT: 11.6/29.5

Na/K/Cl : 145/9.0/107

CT/BT : 730/3.00


Anti HCV: Non-reactive

SGOT/SGPT : 27/16

GDS : 92

Ur/Cr: 14/0.3

CT-Scan kepala

11/03/2015

Kesan: Massa ventrikel III disertai hydrocephalus sesuai gambaran ependymoma

Thoraks

12/03/2015

Kesan: Tidak tampak kelainan radiologik pada foto thoraks

4DIMAS RACHMAWAN SUSANTO

28-07-2000

RM: 223130

MRS: 24-03-2015Dr.dr.Djoko Widodo, Sp.BSS: Nyeri kepala

Di perut ada keluar cairan dari bekas luka operasi

O: KU: Sakit sedang GCS 15

A: Hydrocephalus post V-ShuntRencana operasi minggu 29-3-2015

Puasa

Lapor OK

Konsul anastesi

Siap darah 1 bag PRC

Informed consent

Marking siteLaboratorium

24-03-2015

WBC: 2.45

RBC: 5.91

HGB: 15.1

HCT:45.1

PLT: 297

PT/APTT: 10.4/26.2

Na/K/Cl : 141/3.9/108

CT/BT : 700/3.00

SGOT/SGPT :17/40

GDS : 70

Ur/Cr: 17/4.0

Foto Thoraks

24/03/2015

Terpasang catheter VP-Shunt bilateral yang berjalan dari cranial dengan ujung caudal kiri berada pada subdiafragma kanan dan ujung kanan tidak tervisualisasi kesan dalam rongga abdomen Cor dan pulmo dalam batas normalCT-Scan kepala

24/03/2015

VP-Shunt terpasang dengan ujung tip pada cornu posterior ventrikel lateral kiri

Hydrocephalus

Dandy walker syndrom

HCU

1Bed 1

M. Yusuf

RM: 674967

18-04-1964

Dr. dr.Djoko Widodo, Sp.BSS: Keluhan: BAB berlendir 4x

O: KU: lemah

GCS 7x (E3M4VX)Perban luka : basah

A :

Post removal tumor ec Astrocytoma High Grade IVFD NaCl 0.9% 28tpm

Omperazole 40mg/12 jam/ iv Phenytoin 100mg dalam NaCl piggybag/24jam/iv Sistenol 3x500/NGT Nebulizer ( sesuai TS pulmo Konsul GEH Terapi lain sesuai TS Gizi Klinik dan Pulmo

Lab 23-03-2015

WBC: 17,4RBC: 3,01HGB: 10,5PLT: 350Na: 133K: 3,1Cl: 104GOT: 139GPT: 142Ur/Cr: 17/0,40Albumin : 2,5

GDS : 111Lab (17-3-2015)

WBC : 18.4RBC: 3.65HGB: 12.5PLT: 415Protein total: 5.3

Albumin: 2.9

Globulin: 2.4

Kolesterol total: 231

HDL: 23

LDL: 163

Natrium: 138

2Bed 2Abdullah Rafi 18 / 7 /2006705313

Dr. dr.Djoko Widodo, Sp.BSS: Keluhan : Kesadaran menurun

O: KU : lemah

GCS 12 (E4M5V3)A: - Trauma capitis sedang GCS 9 dengan perbaikan GCS 12 (E4M5V3)- ICH temporal sinistra (PH-6) IVFD RL 12tpm

Ceftriaxone 500mg/12 jam/iv

Ranitidin amp/ 8jam/iv

Ketorolac amp/ 8jam/iv

Mannitol 50cc/ 8 jam/ jika TD > 100

Semax 3x 100 gtt (tetes hidung kiri kanan)

Observasi GCSCT scan kepala 19/3/2015

Pendarahan intracerebri regio temporal kiri

USG Abdomen 19/3/2015

Tidak tampak tanda-tanda laserasi maupun cairan bebas pada USG Abdomen saat ini

Lab 19/3/2015

Wbc: 20.5Rbc : 4.98Hgb : 11.9Plt : 335SGOT/SGPT: 120/66

Na: 149K: 4.5Cl: 114Ur / cr: 20/0.40

3Bed 3

Muh.Rusli

11-11-1981

697429

MRS :

17-01-2015Dr. dr.Djoko Widodo, Sp.BSS : Keluhan : demam

O : KU : SedangGCS : 9x (E4M5Vx)

A :

- Post Craniotomi ec EDH

IVFD Nacl 0,9% 28tpm Sistenol 3x500/KP Omeprazole 40mg/ 24jam/iv Ondansentron amp/ 24 jam/iv Cotrimoxazole 2x2/NGT

Tutup kanul seluruh Cek darah rutin, SGOT, SGPT Terapi lain sesuai TS Gizi Klinik, Pulmo

Lab (20-3-2015)

WBC : 11.3RBC: 4.67HGB: 11.5PLT: 455Ur/Cr: 16/0.54GOT/GPT: 64/212

Albumin: 3.4Na/K/Cl: 130/4.3/94

GDS: 117Foto thorax 18-01-2015

Bronchopnemunia bilateral

CT Scan kepala 17-01-2015

Perdarahan epidural region frontalis dengan fraktur kominutif os frontalis sisi kanan disertai herniasi subfalcine

Hematoma subgaleal dengan emfisema subkutis pada region frontalis sisi kanan

4Bed 4

Rangsong

17/9/1952

695412

MRS :

04-01-2015

DR.dr Nasrullah M. Sp.BSS: sulit dinilai

O:KU:lemah

GCS 8x(E3M4Vx)

A: Post craniotomy e.c ICH parietal

IVFD Nacl 0.9% 18 tpm

Ambroxol 3x1cthNGT Ventolin 2,5mg/8jam nebulizer

Sistenol 3 x 500/ KP/ NGT Tutup kanul 1/2 GV rawat luka dekubitus Rawat trakeostomi Terapi lain sesuai ts gizi klinik,pulmo, rheumatoligi

Foto thoraks (9/3/2015)

Tracheostomy tube terpasang 3.8 cm diatas carina

Dilatatio aortae

Elevasi diafragma kanan

Lab 20-03-2015

WBC: 9.2RBC: 3.45HB: 9.6PLT: 509SGOT: 43

SGPT: 27Albumin: 2.8

As. Urat: 5.6Na/K/Cl : 144/3.6/107Lab 04-03-2015

WBC: 10.0

RBC: 3.31

HB: 9.1

PLT: 313

Ur: 45

Cr:0.64

SGOT: 43

SGPT: 27

CT-Scan (28/1/2015)

-Defect os. Parietal kiri disertai herniasi parenkim

-Enchepalomalacia region temporal sinistra

-sudah tidak tampak perdarahan intraserebri, intraventrikel dan pons

5Bed 5Siti Maryam27/7/1963705430

Dr. dr.Djoko Widodo, Sp.BSS : Keluhan : Kesadaran menurun, demam

O : KU : LemahGCS : 12 (E3M5V4)

A :

- Post ventricular drainage ec IVH ec hemoragik stroke H-6

IVFD RL 20tpm Ceftriaxone 1gr/12j/iv Omeprazole 40mg/ 24jam/iv Paracetamol 1g/ 8 jam/iv Konsul neurologi Konsul kul-kel Konsul Gizi Observasi GCS Cek laboratorium lengkap

Lab 23/3/2015

Wbc: 18.5Rbc : 4.09Hgb : 12.0Plt : 335SGOT/SGPT: 120/66

Na: 145K: 4.1Cl: 110Ur / cr: 20/0.40

6Bed 6

Arsank

704873

20-04-1980MRS:15-3-2015

Dr. dr. Nasrullah, Sp.BSS: Keluhan: Kesadaran menurun

O: KU: SedangGCS 12 (E3V4M5)

A:

Trauma Kapitis Sedang GCS 12

(PH-10)

IVFD NaCl 0.9% 18 tpm O2 10 liter/menit Ceftriaxone 1gr/12j/iv Ranitidin amp/8jam/iv Manitol 100 cc/6jam jika TD > 100 Semax 4x10 gtt

Terapi lain sesuai TS Gizi Klinik

Lab (19-3-2015)

Kolesterol total: 210

LDL: 125

HDL: 49Lab (15-3-2015)

WBC : 12.9RBC: 4.71HGB: 14.3PLT: 263Ur/Cr: 21/0.90GOT/GPT: 50/26GDS: 139Na/K/Cl: 141/3.9/107

CT Scan (24-03-2015)

Subdural hygroma regio frontoparietalis bilateral

Tanda-tanda brain swelling

7Bed 8

M. Juhri

445570

31/12/1956

MRS

1/3/2015Dr. dr. Nasrullah, Sp.BsS: Keluhan: BAB lendir 4xO: KU: sedangGCS 15 (E4M6V5)A : Post op craniotomy ec SDH

IVFD RL 28tpm Bisolvon syrup 3x1cth

Na. Diclofenac 2x1/NGT

Omeprazole 40mg/24jam/iv Konsul GEH

GV rawat luka Terapi lain sesuai TS Gizi Klinik, pulmo, rheuma

Urinalisa (21-3-2015)

pH : 7.5

Nitrit : positif

Blood : +/10

Lekosit : +++/500

Sedimen lekosit : 25

Sedimen eritrosit : 2

Sedimen epitel sel : 2

Lab (20-3-2015)

WBC : 11.0RBC: 2.95HGB: 7.5PLT: 877Na/K/Cl: 141/4.5/105

As. Urat: 4.1

Albumin: 2.5

8Bed 7

Abdul Rauf

677206

01/07/1969

MRS :

25-08-2014Prof. Dr. dr. A. Asadul Islam Sp.BSS: Keluhan : Kejang, keluar darah dari NGT

O : KU : lemah

GCS 7x (E3M4Vx)

NGT : + 500 cc warna kehitaman

A :

- Post repair VP shunt H-8

- Post craniotomy ec SDH

IVFD RL 20 tpm

Ceftriaxone1gr/12jam/iv

Omeprazole 40mg/24jam/iv Phenytoin 100 mg dalam NaCl piggy bag/8 jam/drips

Jika kejang ( diazepam 1 amp dalam NaCl piggy bag/16 tpm

Sistenol 3x500/kp/ngt Awasi KU dan tanda vital Cek darah rutin

Lab (25-3-2015)

WBC : 20,4RBC: 4,20HGB: 12,5PLT: 516GOT/GPT: 88/99Ur/Cr: 28/0.30

Asam urat : 2.8

Protein total : 7.3

Albumin : 3.1

Globulin : 4.2

Kolestrol total : 132

Na/K/Cl : 136/4.7/106Lab (10-3-2015)

WBC : 9.9RBC: 3.68HGB: 11.0PLT: 537

GOT/GPT: 27/41

Ur/Cr: 21/0.38

MSCT Kepala Non Kontras (09-03-2015)

Defect pada os temporalis kiri dengan herniasi parenkim otak region tersebut

Encephalomalacia region frontalis bilateral dan temporoparietalis kiri

Hypertensive Hydrocephalus

Foto thoraks (09/03/2015)

VP shunt terpasang pada hemithorax kanan dengan tip kesan pada rongga abdomen

Tracheostomy tube terpasang pada trachea setinggi 4 cm diatas carina

TB paru lama tenang

Elevasi diafragma kiri

Dilatatio et elongation aortae

Rahmi

706365

8-8-1999Dr andi ikhwan,Sp.BSS: kesadaran menurun

O: sakit berat. Gizi baik

Status lokalis

Tampak hematom pada palpebra kanan.

Nyeri tekan ada

A: trauma capitis sedang GCS 10 O2 10 liter/menit Nacl 0,9% 28tpm Ceftriaxone 1gram/12jam/iv Ketorolac 30mg/8jam/iv Ranitidine 50mg/12jam/iv Mannitol 200cc, maintenance 100 cc/6jam jika TD>100Lab (27-3-2015)

WBC : 18,6RBC: 4.04

HGB: 10.4PLT: 290Ur/Cr: 20/0.40GOT/GPT: 48/22GDS: 128

Na/K/Cl: 139/3.5/108CT scan 27-3-2015

Pendarahan Subarachnoid

- Pendarahan intracerebri lobus temporalis kiri

- Pendarahan epidural regio temporal kiri

- Fraktur os frontalis dextra disertai hematosinus ethmoidalis kanan

- Brain swelling

Foto cervical AP Lateral 27-3-2015

Spondylolisthesis CV C2 terhadap C3,C3 terhadap C4,C4 terhadap C5

PALEM BAWAH

2B2K8 BED2

Hamjaya

676472

04-01-73

MRS

17-03-2015DPJP

Dr.Andi Ichwan,

Sp.BS

S. keluhan: kedua kaki tidak dapat digerakkan

O. KU : sedang

Motorik

5

5

0

0

A.paraplegi ec. Destruksi vertebra thoracal VIIIP/

IVFD. RL :D5= 2:1

Ceftriaxone 1g/12j/iv

Ranitidin amp/12 jam/iv

Methylcobalamin/ 8j/iv

Methylprednisolon amp/8j/iv

Rencana laminektomi -> tunggu jadwalLab

(17/03/15)

BT: 7.00

CT: 3.00

PT/APTT: 11.2/ 27.3

INR: 1.10

GDS: 76

UR/CR: 65/3,5

GOT/GPT: 35/20

NA/K/CL: 142/3.7/106

PALEM ATAS

1.

2B1K5

Nabil anansyah

679109

03-01-2011

MRS

23-03-2015DPJP:

Dr. Nasrullah, Sp. BSS. keluhan nyeri

O. GCS15( E4M6V5)


RC+/+

A.smpost cranioplasti hari- 1p/ instruksi post operasi

- IVFD RL 10tpm

- ceftriaxone 250mg/12/iv

- renitidin 1/2 amp/12j/ iv

- paracetamol 200mg (20cc)/8j/iv

-takar drainase

- jika sadar baik boleh minumLab

(17/03/15)

GDS: 77

UR/CR: 13/0.59

GOT/GPT: 27/12

ALB: 3.5

NA/K/CL: 149/4.6/112

RBC: 4.99

HB: 13.3

HCT: 39.7

PLT: 357

WBC: 10.03

BT: 7.00

CT: 3.00

PT/APTT: 11.1/ 35.2

INR: 1.07

titipanLONTARA 3 BAWAH BELAKANG

1HCU Bed 4

ST. Nurnaini

703931

28/12/1952

MRS :07/03/2015

DPJP

Dr. dr. Djoko Widodo, Sp.BS

S:kesadaran menurun

O: KU:

GCS 5 (E1M5V2)

A: post op H2 ec meningioma

Infus RL 28tpm

Ceftriaxone 1gr/12j/IV

Ketorolac 30mg/8j/IV

Ranitidin 50mg/8j/IV

Headup 300Ganti Verban /2hari

Lab 15/03/2015

RBC : 3,73

WBC : 28,300

HGB : 11,3

HCT : 33

PLT : 308,000

Ur/Cr : 22/0,30

Na/K/Cl : 137/2,8/102

Lab 13/03/2015

RBC : 3,44

WBC : 20, 300

HGB : 10,4

HCT : 31

PLT : 182,000

PT/APTT : 10,8/31

Ur/Cr : 37/0,40

SGOT/SGPT : 22/26

GDS : 100

Alb : 2,5

Na/K/Cl : 140/ 2,7/107

CT-Scan Kepala (tanpa kontras) 07/03/2015

-Massa extraaxil regio frontotemporalis suspek meningioma disertai brain swelling dan tanda-tanda herniasi subfalcine dan trans tentorial

- Hydrocephalus obstruktif

- Encephalomalacia pons sisi kanan

2K3B5

Sampara Dg Sibali

RM : 705407

Tgl lahir

01/07/1963

Tgl MRS

19/03/2015S:

O: Ku = Baik

A : Multiple Abses Cerebri dan CerebellumTerapi sesuai TS Saraf

Tunggu Konfirmasi bagian sarafLab 19/03/2015

WBC: 24.6

RBC: 4.07

HGB: 11.9

HCT: 35.7

PLT: 341000

CT/BT: PT/APTT: GDS: 95

Ur/Cr: 29/0.9

SGOT/SGPT: 24/1.1

Na/K/Cl: 140/3.6/102

HBsAg: nonreactive

MSCT Kepala

20/03/2015

Multiple Abses Cerebri dan Cerebelum

3K4B4

Karmila

RM: 699522

Tanngal lahir:

20-10-1966

Tanggal konsul:09-03-2015DPJP:

Dr.dr.Djoko widodo,Sp.BSS: nyeri kepala, penglihatan kabur

O: status generalisata sakit sedang/ gizi cukup

GCS15

Pupil isokor

A: POH 2 LobectomyPOH 2 LobectomyLab 09-3-2015

HB: 15.9HCT: 45.4WBC : 9.9RBC : 5.04PLT : 234GDS: 102Ur/cr : 23/0.60GOT/GPT : 26/57Elektrolit: Na/K/Cl: 141/4.3/105

LONTARA 3 THT ATAS DEPAN

1K1B3

Sartiani

MR: 705635

Tanggal lahir:

1-5-1963DPJP:

Dr. Willy Adhimarta, Sp. BSS: Nyeri kepala

O: GCS 15

Region occipital sinistra: tampak luka terjahit untuk 5x2 cm, hematoma tidak ada

A: Trauma kapitis ringan GCS 15- RL 10 tpm

- Ceftriaxone 1gr/12j/iv

- Ketorolac 30mg/8j/iv

- Ranitidine 50mg/8j/ivLab (22-3-2015)WBC: 18,8RBC: 4,86HGB: 14,9HCT: 43PLT: 223GDS: 185Ur/Cr: 23/ 0,6

2Simon Seda

705167

01-01-1945

MRS:

17-03-2015

DPJP:S: keluhan : Kesadaran Menurun

O: Sakit Sedang

GCS 11(E3M5V3)

A:

Post craniektomi hari ke-1 SDH tempoparietal sinistra ICH temporal sinistraInstruksi post OP

IVFD RL 28 tpm

Ceftriaxone 1gr/12j/iv

Ranitidin ampl/8j/iv

Ketorolac amp/8j/iv

Feniton 100mg dalam Nacl piggy bag/8j

Cek HB post op

Asam traneksamat amp/8jLab 17-03-2015

RBC : 4.88

HGB: 12.6

HCT: 37.7

PLT:242

PT : 10.5

APPT: 28.5

GDS:190

UR/CR: 25/1.10

SGOT: 31

SGPT: 19

NA/KA/KL:140/4.3/103

3Rukka Lindung

659418

24-4-1959

MRS:

24-3-2015DPJPS: Nyeri kepala

O: Status generalis

KU: Lemah

A: Tumor intrakranialInfus RL: dextrose 5% 2:1

Mannitol 100cc/6 jamLab 16/03/2015

WBC 8750RBC 3.35HGB 10,6HCT 31.1PLT 364GDS 90Ur/Cr 28/0,80SGOT/SGPT 21/18Na/K/Cl 134/4.6/99

4Simon Seda

705167

01/01/1945

MRS

17/03-2015S:

O: status generalisata sakit sedang/ gizi cukup

GCS15

Pupil isokor

A: POH craniectomyCeftriaxone 1gr/12jam/iv

Ranitidin 50mg/8jam/iv

Neurobion 5000iu/24jam/ivLab 1403/2015

WBC 20.61RBC 5.27HGB 10.3HCT 33.9PLT 228000GDS 164Ur/Cr 26/1.0SGOT/SGPT 26/13Na/K/Cl 138/4.6/105

LONTARA 3 ATAS BELAKANG

1K2B6

N. Zulkarnaen

687335

31/12/1962

MRS

!9/03/2015DPJP

dr. Nasrullah Sp.BSS: Tidak ada batok kepala

O: : status generalisata : SS/GC/CMGCS 15 pupil isokor2mm/2mm,RC +/+A: Skull Defect Regio Frontal Dextra

Rencana Cranioplasty hari Selasa 24/03/2015Lab 1403/2015

WBC 7300RBC 5.27HGB 15.3HCT 46PLT 297000CT/BT 800/230GDS 108Ur/Cr 30/0.90SGOT/SGPT 24/28Na/K/Cl 146/4.4/109

2K3B4

Rizaldi Winata

705995

27/12/1997

MRS:

24/03/2015DPJP

Dr. dr. Nasrullah, Sp.BSS: Nyeri kepala

O: Status generalis:

SS/GC/CM

GCS 15

A: TCR GCS 15- RL 10 tpm


- Ranitidine 50mg/8j/iv

- MannitolLab 2403/2015

WBC 10,1RBC 3,88HGB 11,7HCT 35,0PLT 678GDS 85Ur/Cr 14/0,60SGOT/SGPT 53/80

3K4B4

Anggun Febriyani

705459

27/2/2000

MRS:

20/03/2015DPJP: Prof Dr. dr. Andi Asadul I, Sp.BSS: Nyeri kepala

O: Status generalis:

SS/GC/CM

GCS 15

A: TCR GCS 15- RL 10 tpm



Lab 20/03/2015

WBC 9,9RBC 5,07HGB 14,7HCT 43,2PLT 403GDS 131

Na/K/Cl: 141/5,2/106

4Fauzan M N

706124

09/06-2006

25-03-2015

S: Nyeri luka operasi

O :KU baik GCS 15

A: POH 2 CraniectomyRL 20 tpm

Ceftriaxone 1gr/12jam/iv

Ketorolac 30mg/8jam/iv

Burnazin ZalfLab 25/03/2015

WBC 13.5RBC 4.46HGB 13.3HCT 35.5PLT 844GDS 120Ur/Cr 24/0,38SGOT/SGPT 53/80Na/K/Cl 143/4,5/109

LONTARA 4 ATAS BELAKANG

1K7B6

Ayu Andini

22/11/2003

704797

MRS:

14/03/2015S: Lemah kedua tangan dan kakiO: : status generalisata : SS/GC/CMGCS 15 pupil isokor3mm/2mm,RC +/+A: Tetraparese ec SOLTunggu hasil kulturLab 14/03/2015

WBC 7600RBC 4,76HGB 13,2HCT 39,3PLT 500GDS 90Ur/Cr 20/0,40SGOT/SGPT 15/21Na/K/Cl 144/4,4/113

2Putra Ansar

10/05/2014

701432

MRS:DPJP:S: Demam ada, spastik ada

O: status generalisata : SS/GC/CMGCS 15 pupil isokor3mm/2mm,RC +/+A: Post VP shunt- RL 10 tpm



ICU

1.Bed 1

Herman

RM: 70-58-48

24-08-1965

DPJP:

Dr.willy adhimarta,Sp.BSS: Kesadaran menurun

O: KU: lemah

Pupil isokor

drain 100 cc

A:

Post Op cranitomoi decompress + external drainage ec ICH Terapi sesuai Ts anestesi

GV/3 hari

Takar drain/24jamLab 23-03-015

Wbc:14.3

Rbc :372

Hgb :11.3

Hct: 33.8

Plt :303

PT/APTT: 10.3/33.2

GDS: 163

SGOT/SGPT: 24/22

Na/k/cl:148/3.3/112

Ur / cr:51/1.40

HBsAg:non reactive

2.Bed 2

Mastang

699916

01/07/1996

Tanggal Konsul :

04-02-2015

DPJP :

Dr. dr. Nasrullah, Sp.BSS : keluhan sulit dievaluasi

O : KU : sedang

GCS : 6x (E4M2Vx)

A : - SOL Intracranial

Post VP shunt e.c hydrocephalus

post op external drainase ec SOH

Infus RL 20 tetes/menit

Terapi lanjut TS. Anastesi dan BTKV

Ceftriaxone 1gr/12jam/iv

Ganti verban/3 hari

Foto Thoraks PA/AP

(17/02/2015)

Kesan : - Bronchopneumonia dextra

- Tidak tampak tanda-tanda metastasis pada foto thorax ini

Lab 15/03/2015

RBC : 2.97

WBC : 7, 900

HGB : 9, 3

HCT : 27

PLT : 320, 000

Ur/Cr : 33/0, 40

Na/K/Cl : 141/ 3,0/ 106

AGD 15/03/2015

pH : 7,595

PCO2 : 34,8

PO2 : 240,4

SO2 : 99,4

BE : 12,2

HCO3 : 34,0

Laktat darah : 1,4

MSCT Kepala (AX+ Cor) Non Kontras

(12/03/2015)

Kesan : Subdural hematom subkronik

- Massa fossa posterior

3.Bed 5

Herman

RM :70-56-05

21-04-1993

MRS: 21-03-2015

Dr. Willy Adhimarta,

Sp.BSS:kesadaran menurun

O : Ku: sedang

GCS 7x (E2M5Vx)

Pupil isokor

Drain 20 cc

A :

Post op H craniotomy ec ICH temporoparietal sinitra

Terapi sesuai TS anestesi

Takar drain/24 jamLab 24-03-2015

WBC: 6.5

RBC:3.66

HGB: 10.9

PLT: 88

HCT: 32.4

GDS: 148

Albumin: 3,5

Na: 147

K: 2.6

Cl: 109

GOT: 138

GPT: 248

Ur/Cr: 33/1.20

4.Bed 7

Sugiyati

703486

20/02/1953

MRS :

03-03-2015

DPJP :

Dr. dr. Nasrullah, Sp.BSS:keluhan: kesadaran menurun

O : Ku: lemah

GCS 11 (E3M5V3)


Hemiplegia sinistra

A :

-ICH parietal dextra

Stroke hemorrhagic

Post op craniectomy + external drainage POH 2

Terapi lanjut sesuai TS anestesiLab 15/03/2015

RBC : 3,74

WBC : 8,900

HGB : 10,2

HCT : 30

PLT : 165,000

Alb : 2,1

Na/K/Cl : 149/2,8/111

Lab 12/03/2015

RBC : 4,52

WBC : 4,000

HGB : 11,5

HCT : 36

PLT : 74,000

PT/APTT : 10,9/32,2

Ur/Cr : 66/0,56

GDS : 486

SGOT/SGPT : 47/69

Alb : 2,1

Na/K/Cl : 147/2,8/114

Laktat darah : 36,9

Foto thoraks AP/PA

(07/03/2015)

- Terpasang Tracheostomy tube dengan tip berada setinggi 2,27 cm dari carina

- Terpasang CVC pada hemithorax dextra dengan tip berada pada paravertebra kanan setinggi CV Th V

- Cardiomegaly dengan Edema Paru

- Dilatatio aortae

RSUH

ICU bed 4

Franky Sia

036661

06/12/1958

MRS

13/03/2015

DPJP: dr.Willy Adhimarta, Sp.BSS: Nyeritulangbelakang

O: status generalisata : KU membaik

GV, keluarkan pusA: post-laminektomi + GCS 7X, perbaikan GCS 15 Infus RL 28 tpm

Meropenem 1gr/ 12 jam/ IV

Levofloxacin 750 mg/ 12 jam/ IV

Piracetam 3gr/8 jam/IV


GV/ hariLab (19/03/2015)

WBC : 4,800

RBC : 3,53

HGB : 8,6

HCT : 28,5%

PLT : 155,000

Alb : 2, 9

GDS : 114

Na : 142

K : 3,3

Cl : 103

Foto thorax AP (15/03/2015)

Kesan : edema paru

326

RisalDPJP :

Nasrullah,Sp.BSKista Epidermoid Frontal

POH 3-Boleh Rawat Jalan Besok

401

Muhtar

20/4/1950

037334DPJP: dr.Willy Adhimarta, Sp.BSGlioblastoma Multiforme

Edema cerebri-Pro radioterapi

UGD

NurhayatiDPJP :

Nasrullah,Sp.BSTumor Hipofise ResidifRencana op. Removal Tumor via endoscopy trans nasal

PCC

NICU

1Kamar II B

Muh Raif Yamin

22-02-2015

703885DR. dr. Nasrullah, Sp.BSS :keluhan sulit di evaluasi

O : KU sakit sedang

Patensi shunt baik

A : post VP shunt ec hydrocephalus (hr IV)Ceftazidime 110mg/12j/iv

Amikasin 55mg/24j/iv

Terapi lain sesuai TS paediatric

Lab 26-03-15

WBC 9,1

RBC 3,79

HGB 11,9

HCT 36

PLT 442

CT scan kepala (tanpa kontras) 9-3-15

severe Hydrocephalus non communicans

2Kamar IIABy Ny Aztria

18-03-2015

705651

DR. dr. Nasrullah, Sp.BSS : kepala membesar

O : KU sakit sedang

Lingkar kepala 43 cm

A : hydrocephalusTerapi sesuai TS paediatric

Konsul perioperativeFoto thorax 25-03-15

-terpasang gastric tube dengan tip berada pada rongga abdomen

-cor dan pulmo normal

Lab 25-03-2015

WBC 9,2

RBC 3,09

HGB 11,0

HCT 39

PLT 280

GDS 101

Bilirubin total 11,21

Bilirubin direk 0,39

Albumin 3,1

Na/K/Cl 141/4,0/119

CT scan kepala (tanpa kontras) 22-03-15

Severe Hydrocephalus

PICU

1Arkab Manggazali

22-01-2015

705877dr. Willy Adhimarta, Sp.BSS : kejang

O : KU sedang

GCS 15 (E4M6V5)

CT scan subdural hematoma pada regio parietal kiri

A :

Acquired p complex depressed syndrome

Subdural hematoma regio parietal kiri

Rawat sama

Terapi konservatif

Terapi anticonvulsan sesuai TS peadiatricLab 27-03-15

GDS 108

Albumin 3,0

Na/K/Cl 136/4,0/107

Kalsium 8,1Lab 26-03-15

WBC 8,8

RBC 3,36

HGB 10,3

HCT 31

PLT 193CT scan kepala 24-03-15

Tidak tampak kelainan radiologik pada CT scan kepala ini

UGD

1Herlan Jasmin

17-02-1982

706279A: TCS GCS 12IVFD RL 28 tpm

Ceftriaxone 1g/12J/IV

Ketorolac 1 amp/8j/IV

Ranitidin 1 amp/8j/IV

Lab 27-03-15

WBC 15,1

RBC 5,00

HGB 15,5

HCT 44

PLT 334

GDS 173

Ur/Cr 27/0,82

SGOT/SGPT 80/32

Na/K/Cl 144/3,3/110

BT/CT 3,00/7,00

PT/APTT 10,4/23,4CT scan kepala 27-03-15

-contusio cerebri

-brain edema

-multiple fracture disertai multihematosinus

-hematom subgaleal regio frontotemporal kiri

19

_ Koran Bedah Saraf Sabtu 28 Maret 2015 Fix

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