Blogger Gorontalo

Sebagai rangkaian kegiatan Idul Adha 1428 H, penyembelihan hewan qurban di LPMP Gorontalo tadi pagi (10/12) sekitar jam 09.00 Wita telah dilaksanakan yang disaksikan langsung oleh Kepala LPMP Gorontalo Ibu Hj. Luizah Saidi, M.Pd., pejabat struktural dan widyaiswara.

Kasubag Umum Bapak Eky Aristanto P. Punu, SE. MM. yang juga sebagai Panitia Idul Adha, dalam laporannya mengemukakan bahwa sebanyak 3 ekor sapi yang disembelih pada tahun ini dan daging qurban tersebut akan didistribusikan kepada masyarakat di sekitar kantor, selain tentu kepada karyawan baik tenaga honorer maupun tenaga abdi. Menurutnya, “alhamdulillah sejak LPMP Gorontalo berdiri tahun 2003 setiap tahunnya LPMP Gorontalo pada hari raya haji selalu ikut berqurban, dan diperuntukkan bagi masyarakat kurang mampu, soal jumlah besar kecil tergantung pada kondisi ekonomi”.

Sementara itu dalam sambutannya Kepala LPMP Gorontalo Ibu Hj. Luizah Saidi, M.Pd.
mengemukakan, bahwa hal yang penting dalam pelaksanaan Idul Qurban ini adalah bagaimana mengaplikasikan qurban untuk menambah keimanan dan ketaqwaan kepada Allah SWT. Menurutnya, walau kondisi ekonomi saat dilanda krisis global namun itu tidak menjadi kendala, karena menyemarakkan kurban adalah suruhan pada setiap muslim yang mampu suatu bukti kecintaan pada sang Khaliq. Disisi lain kata beliau, manfaat kurban selalin disuruh belajar iklas, juga rasa tanggung jawab paling utama digambarkan didalam sejarah kurban tersebut. maka itu umat Islam harus belajar dengan dengan sifat Nabi Ibrahim. dimana rela mengorbankan harta benda termasuk perintah menyembeli anaknya Ismail demi kecintaan pada Allah.

Seusai menyampaikan sambutan, Kepala LPMP Gorontalo Ibu Hj. Luizah Saidi, M.Pd.
berkenan menyerahkan hewan qurban secara simbolis kepada Panitia, yang diwakili oleh Kasubag Umum Bapak Eky Aristanto P. Punu, SE. MM.

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Sebenarnya postingan ini telah ada di blog saya terdahulu, namun dikarenakan blog saya di aguslahinta.com lagi bermasalah, maka tulisan ini saya RePost lagi di wordpress. on Dec 4th, 2008 …bahwa hiduplah untuk memberi sebanyak-banyaknya bukan untuk menerima sebanyak-banyaknya...(Harfan Efendi Noor) Laskar Pelangi, film fenomenal di tahun 2008 ini akhirnya bisa didatangkan dan diputar secara besar-besaran dan Gratis di [...]

Akhirnya, tibalah kami disini. Di ujung perjalanan. Majalah Online Komunitas Blogfam, bz!, yang hadir dan mengalir sejak 6 Februari 2006 berada pada suatu titik dimana kami mesti berhenti. Entah sejenak atau seterusnya. Saya tak tahu.  Tapi moga-moga saja, “nafas” bz! masih akan terus berdenyut, walau tak sesering dulu (terbit tiap tanggal 6 setiap bulan).

Yang jelas, seperti ungkap Sa, Pemimpin Redaksi bz! pada kata pengantar di edisi pamungkas bz!

Kombinasi aktivitas di luar blogging, telah cukup menghabiskan waktu luang kami.
Waktu menjadi hal yang mahal untuk dapat digunakan dengan mudah. Masih ada semangat untuk terus berusaha kembali, namun belum dapat kami ungkapkan kapan waktunya. Tanpa mengungkapkan janji, kami hanya berharap agar artikel yang telah hadir selama ini dapat memberikan informasi dan memancarkan ekspresi kami dalam mengisi dunia blogging.

Terimakasih untuk para pembaca setia bz! Terimakasih pula untuk seluruh jajaran responden, kontributor dan juga pemasang iklan di bz!. 

Maafkan jika selama 3 tahun kehadiran kami di jagad maya terdapat hal-hal yang kurang berkenan dihati. Sebagai salah satu perintis majalah online ini dan masih “mengawal”-nya sebagai Redaktur Pelaksana selama 2,5 tahun hingga akhir perjalanan itu tiba, saya bangga dan merasa terhormat bekerja sama dengan kawan-kawan redaksi bz! yang sangat hebat, loyal dan berdedikasi memberikan kontribusi terbaik bagi dunia blog pada khususnya dan tentu masyarakat Indonesia pada umumnya, tanpa pamrih dan imbalan apapun. Terimakasih atas kebersamaan yang indah ini. “I’ll miss your SMS in the midnight, Sa!” :D.

Sungguh merupakan suatu hal yang menyesakkan dada ketika saya mesti menutup pintu ruang maya redaksi bz!. Mudah-mudahan bukan untuk selamanya. Dan masih akan ada secercah cahaya dan semangat untuk menghidupkannya kembali. Suatu ketika. Suatu waktu. Entah kapan.

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a. Mencetak symbol * dengan menggunakan for bersarang kali ini akan membahas bagaimana mencetak * dengan format manipulasi input output dan penggunaan for untuk mencetak permasalahan : bagaimana kita ingin menampilkan output seperti * * * * * * * * * * algoritma : 1. mendefinisikan konstanta maxs sebagai batas / syarat perulangan 2. Deklarsai variabel baris dan kolom untuk melakukan perulangan [...]

Di bulan Desember banyak perayaan yang menyentuh jiwa, di antaranya adalah perayaan Hari Ibu. Tentu kita selalu punya banyak kenangan tentang ibu yang melahirkan kita, sehingga terlalu banyak kata-kata yang bisa kita pakai untuk melukiskan hal tersebut.

Sangat sayang bila moment seperti ini dilewatkan begitu saja. Nah bila kalian sulit berbicara, atau menulis karangan, maka ungkapkanlah pesona kalian terhadap ibu melalui PUISI.

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.: kemarin 10 dzulhijah merupakan hari berkabung sedunia, dimana banyak hewan seperti sapi, kambing, dan unta tewas dengan sadis bahkan dimutilasi oleh tangan-tangan yang tak bertanggung jawab….! .: Banyak keluhan ke LPH (lembaga pengaduan hewan) yang mengaku bahwa kehilangan Orang Tuanya .: Hehe….tapi itu semua emang udah semestinya, bahkan itu udah kewajiban dan tugas kita untuk berqurban [...]

GASTROSTOMY TUBE REPLACEMENT

There are many different procedures that may be used to place feeding gastrostomies and dozens of commercially available gastrostomy tubes. Familiarity with the basic techniques used to create gastrostomies and the characteristics of common gastrostomy tubes is helpful in solving problems with their function and selecting appropriate replacement tubes.

PLACEMENT OF GASTROSTOMY TUBES

Formal surgical techniques for the placement of feeding tubes have been used for more than a century. Sedillot is given credit for having performed the first open human gastrostomy in 1845. However, the first postoperative gastrostomy survival was not reported until 30 years later. The evolution of techniques in surgical gastrostomy has a colorful history, with many contributors. Three main procedures that remain in use today are the Stamm (described in 1894), the Witzel (described in 1891), and the Dupage and Janeway (described in 1913) (Figure 53-1). Operative gastrostomies require a laparotomy and general anesthesia. They all share the common goal of providing long-term access to the stomach for feedings or decompression while attempting to minimize the potential for gastric leakage.

Each of the techniques attempts to create a leakprool interface between the stomach, the feeding tube, and the anterior abdominal wall. The Stamm gastrostomy secures the stomach to a feeding tube using a double purse-string suture to invaginate the stomach about the feeding tube (Figure 53-1A). The Witzel technique plece the feeding tube through a seromuscular tunnel in the stomach wall (Figure 53-1B). The Janeway technique creates a formal tunnel form a gastric flap to envelop the feeding tube and form a gastrocutaneus stoma (Figure 53-1C). These surgical gastrostomies are considered long-term, semipermanent stomas.

Figure 41-18. A. Various types of gastrostomy tubes. 1, Polyurethane catheter with collapsible foam flange (CORPAK MedSystems of Kentec Medical Inc, Irvine, CA). 2, Silicone catheter (American Endoscopy [Bard Interventional Product, Billerica, MA]). 3, Latex catheter with a movable external bolster and an internal mushroom or de Pezzer-type flange on the end (American Endoscopy [Bard Interventional Product, Billerica, MA]). 4, Balloon (Foley catheter (Wilson-Cook Co., Wilston-Salem, NC). B. A user-friendly gastrostomy tube is supplied by CORPAK MedSystem (Wheeling, IL). The tube is packaged with lubricant, a prefilled syringe for inflating the balloon, and an axtension set. The color-coded inflation valve indicates ube size (12-24 Fr). The silicone tube uses a aretention balloon and a movable bolster, similar in design to a Foley catheter. Note that the retention bolster is designed to prevent inward migration of the tube and is not to be an anchoring device sutured to the skin. C, Placement of the CORPACK feeding tube and inflation of the balloon. Note that the bolster on the external tube is advanced to the skin to secure the tube. D, A standard Foley catheter may serve as a more specialized feeding tube replacement. The latex balloon may deflate or be weakened by gastric acid; so, this catheter is not ideal for long-term use. In addition, unless the Foley catheter is secured to the skin, it may migrate and he balloon may cause a pseudo obstruction.

TEXT BOOK : CLINICAL PROCEDURES IN EMERGENCY MEDICINE

OPERATIVE INDICATIONS AND CONTRAINDICATIONS

Neurologic disease constitute the most frequent indication for a gastrostomy tube. Facial fractures, oropharyngeal trauma, tracheal and laryngeal injuries may be indications for placement of a temporary feeding gastrostomy. Rare indications for gastrostomy include enhancement of nutrition by continuous feeding in severely debilitated patients who still are capable of oral intake, provision of a route for bile replacement in patients with an external biliary fistula, and they need for long-term gastric decompression. Indications for gastrostomy tube placement in children include neurologic diseases, facial reconstructive surgery for congenital deformities and maxillofacial trauma. Young children who require long-term administration of unpalatable medications or dietary component may also require a gastrostomy. Tube duedenostomies are created almost exclusively for duodenal decompression after partial gastrectomy with Billroth II anastomoses. Permanent jejunostomies are rarely used. Tube jejunostomy is indicated when the proximal bowel has a fistula or is obstructed, when recovery of small bowel motility is anticipated long before recovery of gastric motility, and after a gastrectomy.

Contraindications for gastrostomy feeding include severe gastroesophageal reflux, upper gastrointestinal fistulas, repeated aspiration of gastric content, and intestinal or gastric outlet obstruction. Jejunal feeding is contraindicated if the highly osmolar feeding solutions required for jejunal feeding are poorly tolerated and cause copious diarrhea.

INDICATIONS AND CONTRAINDICATIONS FOR TUBE REPLACEMENT

The nursing home patient with a nonfunctioning or displaced feeding tube represents a common ED (emergency department) presentation. The clinician cannot always determine the location of the original feeding tube by simply looking at the patient who arrives in the ED for tube replacement. Nevertheless, the emergency clinician should attempt to ensure that the terminal end of a replaced tube is in the same viscus as the original. External inspection may or may not reveal where a feeding tube should terminate. A de Pezzer (mushroom) or Foley gastrostomy tube is designed only for intragastric termination. Some tube have two lumina, one terminating in the stomach for decompression and the other in the small bowel for feeding. These can be confused with tubes that have two entrances to one lumen (one for continuous feeding and the other for medications) and tubes that have a second lumen leading to an inflatable balloon.

The clinician has a few options when faced with the task of replacing a feeding tube. Unfortunately, old records or nursing home personnel rarely give specific information that is helpful to the emergency clinician. If the tube is blocked, yet still present, a contrast study may demonstrate the final position of the tube. If only a stoma exists, one may request that the nursing home describe or send the prior tube to the ED. If a blocked tube is removed, it can be replaced with a similar device. If no surgical scar is seen at the stoma site, the tube is almost certainly a G tube, or a G tube that terminated in the jejunum. Placing a new tube followed by a contrast study usually settles the issue and allows the clinician to make decisions on balloon inflation, or possibly substitute a new device. When in doubt there is no downside of passing a Foley catheter without balloon inflation, taping it to the skin, and referring the patient to a consultant or the original referring clinician. It is unwise to avoid placement of some type of tube since the stoma will quickly close and may necessitate a more complicated procedure later. The only real concern of placing a gastric tube into the jejunum is that the balloon will procedure intestinal obstruction if it is fully inflated.

If the tube is nonfunctioning yet still in place, the clinician must make a judgment as to the risk versus benefit of removal and replacement versus an attempt st unclogging the tube (see subsequent section on unclogging). The major concern is that a new tube may be misplaced (i.e., into the peritoneal cavity). If it appears that the patient has an easily removable tube. If the patient has signs of a complication (e.g., infection, ileus, intestinal obstruction), surgical consultation is warranted.

Ease and safety of transabdominal feeding tube replacement depend on the surgical procedure performed and the length of time since placement of the feeding tube. For a simple gastrostomy, the insertion site of the tube through the gastrointestinal wall is sealed by either annular or placation sutures. The gastrointestinal wall is approximated to the peritoneum around the site of penetration to provide a futher leakage barrier. The tube is then secured outside the abdominal wall. A Witzel tunnel is a serosal tunnel created when the feeding tube is placed along side the viscus for a distance after exiting the viscus, and the bowel is pulled up over it along this distance and secured with sutures (see Fig. 41-17). In one type of hickman catheter jejunostomy, the tube passes through a Dacron cuff and a Witzel tunnel. Reinsertion of a Hickman catheter through a tortuous, rough Witzel tunnel is unlikely to be simple. A percutameous gastrostomy may have been placed without any attempt to affix the stomach to the abdominal wall.

Nonoperative tube replacement techniques are safe only through an established tract between the skin and the bowel. Catheter replacement should not be attempted in the immediate postoperative periode. A simple gastrostomy takes about a week to form a tract. A Witzel tunnel may take up to 3 weeks after the operation to mature sufficiently for safe nonoperative tube replacement. A nonfunctional tube can still serve as the stent for the gastrostomy tract and should not be removed if it cannot be promptly and safely replaced.

INTERNET :

Alternatively, gastrostomy tubes can be placed under endoscopic guidance, using a much smaller incision (percutaneous endoscopic gastrostomy tube placement, or PEG). PEG tube placement can generally be performed under local anesthesia rather than general anesthesia. An endoscope is passed into the mouth, down the esophagus, and into the stomach. The surgeon can then see the stomach wall through which the PEG tube will pass. Under direct visualization with the endoscope, a PEG tube passes through the skin of the abdomen, through a very small incision, and into the stomach. A balloon is then blown up on the end of the tube, holding in place. PEG gastrostomy tubes avoid the need for general anesthesia and a large incision.

A small, flexible, hollow tube (catheter) with a balloon or flared tip is inserted into the stomach. The stomach is stitched closed around the tube and the incision is closed.

TRANSABDOMINAL FEEDING TUBE REPLACEMENT……(to be continue ya….)

Usai sholat Idul Adha bersama seluruh keluarga di lapangan Mesjid Al-Madani Perumahan Cikarang Baru, Senin (8/12) saya bergegas menuju area tempat penyembelihan hewan kurban dibelakang rumah yang dilaksanakan oleh pengurus RT 02/RW 10 tempat dimana saya bermukim. Ini adalah kali pertama saya melakukan ibadah kurban di RT, karena 4 tahun berturut-turut, saya menunaikan ibadah ini dengan membeli kambing dan mengurbankannya di Yogya, kampung halaman istri. Kebetulan saya, beserta 6 orang tetangga lainnya “berpatungan” membeli satu ekor sapi untuk dikurbankan pada hari itu. Alhamdulillah, di RT saya terkumpul 2 ekor sapi dan 3 ekor kambing kurban.

Area penyembelihan terletak disamping “anak” sungai Kalimalang yang mengalir melewati kawasan Perumahan Cikarang Baru. Saya mengenakan baju seragam komunitas blogger Anging Mammiri Makassar yang berwarna hitam selain sebagai usaha memasyarakatkan blog pada masyarakat sekeliling saya (terbukti selama acara penyembelihan dan pemutilasian, banyak warga yang bertanya pada saya apa sih blogger itu, dan saya menjelaskannya dengan senang hati) juga sebuah upaya “solidaritas duka cita” buat para hewan kurban yang menemui ajal pada hari itu

Sapi “patungan” saya sebelum prosesi penyembelihan dimulai

Kurang lebih 20-an orang berkumpul ditempat tersebut tidak termasuk anak-anak berusia belia ingin ikut menyaksikan prosesi penyembelihan hewan kurban. Semuanya terlihat sangat antusias. Istri dan anak-anak saya hanya menonton dari jauh. Tidak berani mendekat. Seorang tukang jagal spesialis bertugas melakukan tugas mulia itu. Sapi “patungan” saya dapat giliran kedua, setelah sapi pertama dengan sukses disembelih.

Pengikatan sapi kurban sebelum disembelih

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