bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of postoperative discitis: A review of 31 patients
Authors: Singh Deepak , Singh Neha , Das Praveen , Malviya Deepak
Published: January 2022

Background: The aim of the study was to retrospectively evaluate the outcome of medical management of postoperative discitis (POD). Materials and Methods: A total of 31 patients treated for POD were included in the study. Clinical, radiological, and laboratory data of all patients were collected and evaluated. All patients were treated initially with bed rest and antibiotic therapy after radiological diagnosis. Surgical management was undertaken after failure of 4 weeks of conservative management. All cases were followed clinically with laboratory and radiological investigations. Results: Five cases failed to respond to medical management and were treated surgically with debridement and transpedicular fixation. All patients showed clinical recovery till the last follow-up. Conclusion: Early diagnosis and proper management are the keys to successful outcome of postoperative spndylodiscitis. Surgical debridement and fusion are required when conservative treatment fails.
Scedosporium apiospermum: An emerging fatal cause of fungal abscess and ventriculitis after near-drowning
Authors: Lee Min-gi , Choi Jin-gyu , Son Byung-chul
Published: January 2022

Herein, we describe a fatal case of central nervous system (CNS) pseudallescheriasis following near-drowning. A 13-year-old boy, who had been successfully resuscitated after near-drowning, presented with a transient episode of mental confusion during a hospital stay after recovering from severe aspiration pneumonia and respiratory failure. A magnetic resonance imaging (MRI) scan of the brain showed a small brain abscess in the left basal ganglia and ventriculitis in the left lateral ventricle. The brain abscess and ventriculitis did not respond to 4 weeks of antibiotic treatment and appeared even worse on a follow-up MRI. A diagnosis of CNS pseudallescheriasis was only possible with invasive stereotactic biopsy and aspiration of the abscess that showed the presence of hyphae and Scedosporium apiospermum. CNS pseudallescheriasis did not respond to multiple combinations of antifungal agents, including amphotericin B, isoconazole, itraconazole, and voriconazole. Two ventricular drainages and insertion of Ommaya reservoirs with intraventricular injection of voriconazole were insufficient to halt the infection. The patient passed away from sudden septic shock 2 months after identification of the brain abscess and ventriculitis. The patient's diagnosis was delayed because multiple examinations of the cerebrospinal fluid did not show positive cultures and could only be obtained from the aspirates of stereotactic biopsy. Physicians should be aware of CNS pseudallescheriasis associated with near-drowning because of the difficulty of diagnosis and the high mortality rate (70%) owing to poor responses to currently available antifungal agents.
A rare case report of multiple intracranial aneurysms with factor VII deficiency
Authors: Gupta Pankaj , Sharma Arvind , Singh Jitendra , Tanwar Akanksha
Published: January 2022

Pathogenesis of intracranial aneurysms is multi-factorial. Origin of aneurysm may be acquired or genetic, and there may be more than one aneurysm simultaneously, or there may be the formation of a new aneurysm after treatment of previous one. Collagen vascular disorders, neurofibromatosis, polycystic kidney disease, and so many other disorders are associated with multiple intracranial aneurysms. As Factor VII deficiency is also genetic in origin, there might be a correlation between deficiency of the same with multiple intracranial aneurysms. Only one such case is reported in the literature and we are reporting such a rare case having a similar association.
Far-lateral transcondylar approach to anterior foramen magnum lesions - Our experience
Authors: Pai S , Raghuram G , Keshav G , Rodrigues Elvis
Published: January 2022

Background: Initial surgical management of the anterior foramen magnum lesions through the posterior approaches was fraught with unacceptable morbidity, mortality, and incomplete removal. The far-lateral approach provides excellent exposure and access to these lesions resulting in complete excision of these lesions with reduced frequency of unwanted complications. Materials and Methods: Eight patients with lesions anterior to the brainstem and upper cervical cord were surgically treated using the far-lateral transcondylar approach. Two of these patients had a meningioma while three patients had “white epidermoid.” One patient had a vertebral artery (VA) aneurysm while another was a rare case of lower brainstem compression by the VA and the last was a clival chordoma. The technical aspects of this surgical procedure are briefly illustrated in this article. Results: Total excision was achieved in five neoplastic cases while subtotal excision was done in one case. The VA aneurysm was satisfactorily clipped while in the brainstem compression patient, microvascular decompression was done. The VA aneurysm patient developed postoperative lower cranial nerve palsies. There were no fresh postoperative deficits in any of the other patients. One patient had an unexplained sudden cardiorespiratory arrest 18 h after the surgery and succumbed. One patient had cerebrospinal fluid (CSF) otorrhea which was satisfactorily managed by intrathecal CSF drainage. Conclusion: The far-lateral transcondylar approach provides excellent approach to lesions located anterior to the brainstem and upper cervical cord. Total excision of these benign lesions is safely possible through this approach.
Effect of local N-acetyl-cysteine in the prevention of epidural fibrosis in rat laminectomy model
Authors: Bahrami Reza , Akbari Ehsan , Rasras Salih , Jazayeri Nematollah , Khodayar Mohammad , Foruozandeh Hossein , Zeinali Masoud , Kartalaei Mozhdeh , Ardeshiri Mohammad , Baiatinia Farshid , Ghanavatian Mohamad
Published: January 2022

Background: Epidural fibrosis is a major contributing factor to the onset of failed back syndrome. Many studies have attempted to prevent this physiological response. Interestingly, N-acetyl-cysteine (NAC) has been effective in some cases in the treatment of pulmonary fibrosis. Objective: The objective of this study was to determine whether local NAC is an effective way to prevent epidural fibrosis after laminectomy in rats. Materials and Methods: Twenty Wistar rats were used in this study. Animals were divided into two groups: NAC group and a control group. We performed two-level laminectomy (L4–L5) in these rats. Rats in the control group just had laminectomy, and in the other group, L4 and L5 laminectomy followed by local treatment with NAC. Four weeks later, the rats were killed, and the laminectomy level was subjected to histopathological examination to evaluate epidural fibrosis and fibroblast density. Results: Histopathological examination showed that after 4 weeks of surgery the NAC group had significantly less epidural fibrosis and fibroblasts compared with control group. Conclusion: Our findings indicate that NAC decreased spinal epidural fibrosis after laminectomy in rats.
Congenital skull anomaly with multiple brain stones and symptomatic meningioma of medial sphenoid wing
Authors: Chaturvedi Monali , Janu Vikas , Kumari Rima , Chaturvedi Sujata , Jain Mukul , Jha Deepak
Published: January 2022

Intracranial calcifications are not uncommon and are mostly seen with intracerebral hematomas, tuberculomas, and brain tumors. These lesions may be intra- or extra-axial and occasionally pose challenge in the diagnosis. We report a case of multiple intracranial extra-axial calcifications with congenital skull anomaly and multiple meningiomas. Authors could not find similar case reported in the literature and present their findings and discuss relevant literature.
Osteoporosis presenting as low backache: An entity not uncommon to be missed
Authors: Sarmast Arif , Kirmani Altaf , Bhat Abdul
Published: January 2022

Introduction: Low backache (LBA) is highly prevalent in osteoporotic patients and affects their quality of life. Overall, osteoporosis incidence is greater in females than in males, and osteoporotic fractures typically occur with only modest or moderate trauma. Aims and Objectives: To evaluate osteoporosis as a cause of LBA in patients attending a neurosurgical outpatient department and to study various risk factors associated with it. Materials and Methods: The study entitled “Osteoporosis presenting as LBA: an entity not uncommon to be missed” was a 2-year hospital-based study conducted from August 2014 to July 2016 in a prospective manner and included 100 patients of osteoporosis with LBA. Analysis of records included their chief complaints, signs and symptoms, diagnostic investigations performed, treatment modalities they underwent, and further recommended management carried on them. Results: Out of total 100 patients evaluated, 33 (33%) were male and 67 (67%) were female; the age of patients was in the range of 35–70 years (mean 56.54 ± 91). The number of patients with a significant medical or surgical history was 31 (31%). The history of drug intake such as thyroxine, steroids, and antiepileptics was present in a total of 11 patients out of which 10 were female and one was male. Regarding lifestyle characteristics of studied patients, a total number of 72 (72%) were having sedentary habits with 15 (45.5%) males and 57 (85.1) females, the total number of moderate workers was 19 (27.3) males and 10 (14.9%) females, and heavy workers were 9 (9%) with 9 (27.3) males and 0 (0%) female. Conclusion: LBA is highly prevalent in osteoporotic patients especially in women. The incidence of osteoporosis and LBA increased with low body mass index, increasing age, and duration of menopause. The various risk factors for osteoporosis include smoking, history of medical diseases such as diabetes mellitus, history of hysterectomy, and history of antiepileptic, thyroxine, and steroid intake.
Nonmissile anterior skull-base penetrating brain injury: Experience with 22 patients
Authors: Lan Zhigang , Richard Seidu , Ma Lu , Yang Chaohua
Published: January 2022

Background: Nonmissile anterior skull-base penetrating brain injuries (NASBPBIs) have specific characteristic features that are different from missile injuries. Our study presents our experiences on the characteristic features as well as management of NASBPBI. Materials and Methods: We retrospectively reviewed 22 consecutive patients with NASBPBI managed at our institute during a 13-year period. The mechanism of injury, clinical investigations, and complications were analyzed, with more emphasis on diagnostic and treatment regimen. Results: The 22 cases included in our study comprise of 20 males and 2 females. Majority (72.7%) of the patients were adults with a mean age of 27.5 years. The mechanisms of injury often include accidental fall, either onto a small-diameter sharp object (10 cases) or while carrying such an object in the hand (4 cases). The other common mechanisms were stabbing, accident, or during an altercation (8 cases). Clinical manifestations included periorbital hematoma (10 cases, 45.5%) and cerebrospinal fluid rhinorrhea or orbitorrhea (4 cases, 18.2%) as well as signs of embedded foreign object (8 cases, 36.4%). We performed emergency craniotomy in 21 cases and skin debridement in one case. Postoperative complications were abscess (1 case), epilepsy (1 case), and traumatic carotid-cavernous fistula (1 case). Conclusion: Nonmissile injuries are generally on the rise and therefore deserve more attention. We observed that clinical outcomes were excellent in 14 (Glasgow Outcome Scale [GOS] score of 5) and good in the remaining 8 patients (GOS of 4) during 6-month–10-year (mean 4.6 years) follow-ups.
Acute subdural hematoma evacuation: Predictive factors of outcome
Authors: Lavrador José , Teixeira Joaquim , Oliveira Edson , Simão Diogo , Santos Maria , Simas Nuno
Published: January 2022

Background: Acute subdural hematoma (aSDH) is a major cause of admission at Neurosurgical Emergency Department. Nevertheless, concerns regarding surgical indication in patients with multiple comorbidities, poor neurological status, antithrombotic therapy, and older age still persist. Therefore, a correct recognition of predictive outcome factors at hospital discharge is crucial to an appropriate neurosurgical treatment. Methods: Eighty-nine medical records of consecutive patients with age ≥18 years old who were submitted to aSDH evacuation between January 2008 and May 2012 were reviewed. Demographic characteristics, neurological status on admission, anticoagulant or antiplatelet therapy, and outcome on discharge were collected. Patients with insufficient data concerning these variables were excluded from the study. Results: Sixty-nine patients were included; 52% were male; 74% were older than 65 years; 41% were under oral antithrombotic therapy (OAT); at admission, 54% presented with Glasgow coma scale (GCS) ≤8; 23% were submitted to a craniectomy instead of a craniotomy; 26% of the patients died, 32% were dependent, and 42% were independent on discharge. Crude analysis revealed craniectomy, A/A pupils, GCS ≤8 at admission statistically significant related with the worst outcome (P < 0.05). In the adjusted evaluation only A/A pupils (P = 0.04) was associated to poor outcome (spontaneous etiology P = 0.052). Considering daily living independency at hospital discharge, either male gender (P = 0.044) and A/A pupils (P = 0.030) were related to the worst outcome. No effect of age in outcome was observed. Conclusions: Male gender and A/A pupils are associated with lower probability of achieving independency living at hospital discharge. A/A pupils, low GCS at admission, spontaneous etiology, and craniectomy were associated with the worst outcome. Age and OAT were not predictive factors in this series. Caution should be taken when considering these factors in the surgical decision.
Favorable outcome of endovascular treatment for intracranial aneurysms: A single-center study in Thailand
Authors: Withayasuk Pattarawit , Churojana Anchalee , Songsaeng Dittapong , Aurboonyawat Taweesak , Chankaew Ekawut
Published: January 2022

Purpose: The purpose of this study is to collect the information on patients with intracranial aneurysm (IA) receiving endovascular management in Siriraj Hospital, Mahidol University, Thailand. Materials and Methods: We retrospectively reviewed data from patients with IA who underwent endovascular treatment from January 1997 through July 2013. We collected patients' demographic data including age, sex, clinical presentations, and aneurysmal profiles, as well as endovascular treatment technique, complications, angiographic results, and regrowth rate. Treatment results included success rate, clinical findings during follow-up, and regrowth rate. Results: We reviewed data from 497 patients with 636 aneurysms (female:male ratio, 1.9:1; age range, 15–90 years; mean age, 59.18 years) and 69% presented with rupture. One hundred and twenty patients with 127 aneurysms received endovascular treatment. The most common location for endovascular treatment was the posterior communicating artery (15.8%), and endovascular techniques were used most often for posterior circulation and paraclinoid aneurysms. The success rate was approximately 99.2% with a 16.5% regrowth rate and no rebleeding. Regrowth rate did not correlate with immediate postoperative angiographic findings. We encountered 23 complications (18.1%); most commonly, intra-procedural rupture (7/23). Good outcomes occurred in approximately 95.9% of the patients. Conclusions: The success rate for endovascular treatment was >90%. Regrowth rate and clinical outcomes were within standard limits. Posterior circulation and paraclinoid aneurysms were our main targets. We tended to use fewer devices and simpler techniques to secure ruptured IA; however, the regrowth rate was similar to that using device-assisted techniques in other studies. We found no significant factors affecting regrowth rate, including immediate posttreatment angiographic results.
Management of recurrent tumefactive multiple sclerosis: Case report and literature review
Authors: Rissardo Jamir , Caprara Ana
Published: January 2022

Tumefactive multiple sclerosis (MS) is characterized by the presence of a single MS-plaque in the brain. It mimics tumors due to large size, mass effect, and enhancement patterns. Refractory intracranial hypertension due to tumefactive MS requiring decompressive craniectomy (DC) was reported in five cases. However, none of these cases were documented new lesions during the follow-up. We report a case of a 28-year-old female admitted with acute right hemiparesis, headache, and nausea. A brain magnetic resonance imaging (MRI) revealed a left parietal lobe lesion. Within 4 days, she became comatose. Computed tomography (CT) scan revealed the left uncal herniation. DC and resection of the lesion were carried out. Histopathology revealed active demyelinating disease. After 11 years of the first attack, she went to the emergency department due to headache and left hemiparesis. Head CT scan revealed a hypodense area in the right frontal lobe. Three months later, the patient was asymptomatic, and new MRI did not show new lesions.
Correlation of pathological complete response with outcomes in locally advanced breast cancer treated with neoadjuvant chemotherapy
Authors: Choudhary Priyanshu , Gogia Ajay , Deo S. V. S. , Sharma Dayanand , Mathur Sandeep R. , Batra Atul , Raju Sagiraju Hari Krishna
Published: January 2022

Background:

Neoadjuvant chemotherapy response rates in locally advanced breast cancer (LABC) vary significantly among Indian patients, and the factors affecting pathological complete response (pCR) rate are not clear in this population.

Objectives:

This study was aimed at identifying the various clinicopathological features associated with achieving pCR and its effect on disease-free survival (DFS) and overall survival (OS) among Indian women diagnosed with LABC.

Materials and Methods:

Women diagnosed with LABC between 2013 and 2019 and who received neoadjuvant chemotherapy followed by surgery and radiotherapy were ambispectively analyzed for clinicopathological responses and survival outcomes. Factors associated with pCR and the role of pCR as a prognostic factor for survival outcomes were examined.

Results:

After neoadjuvant chemotherapy, pCR was achieved in 99 (23.3%) patients, with the highest rates noted in patients with triple-negative breast cancer (TNBC) and human epidermal growth factor receptor 2 (HER2)-positive tumors. Compared to hormone receptor-positive tumors with HER2-negative status, all other tumor groups had significantly higher odds of achieving pCR after neoadjuvant chemotherapy (TNBC: adjusted odds ratio [aOR], 4.58 [95% CI, 2.20–9.53]; hormone receptor- and HER2+: aOR, 3.93 [95% CI, 1.66–9.27]; hormone receptor + and HER2+: aOR, 2.78 [95% CI, 1.20–6.44]). Hormone receptor status and attainment of a pCR after neoadjuvant chemotherapy were associated with better DFS and OS outcomes particularly in patients with HER2-positive and TNBC tumors.

Conclusions:

Patients who attain a pCR following neoadjuvant chemotherapy have improved survival outcomes; pCR rates vary by hormone and HER2 receptor status. Therapeutic approaches such as anti-HER2 and platinum-based regimens may be considered for achieving better pCR rates. The use of biomarkers for the identification of individuals with breast cancer who will not benefit from neoadjuvant chemotherapy should be considered along with early cancer detection strategies.
To “P” or not to “P”, that is the question
Authors: Darling H. S.
Published: January 2022

Best medicine practice is thought to be based on evidence. Inferential statistics allow us to establish the strength of evidence in favor of or against a new research finding. The P value has been considered a reliable universal marker indicative of statistical significance of a study, thus driving the majority of practice-changing developments. Of late, the reign of the P value has been increasingly challenged by failure of replication of results in successive studies necessitating withdrawals of drug approvals. For the purpose of this narrative review, we performed a detailed literature search to identify relevant articles from the PubMed database and Cochrane library. We aimed to evaluate the drawbacks of the utilization of P value in a dichotomous way around a fixed cut-off of 0.05. Our review suggests that the P value must be interpreted as a continuum with smaller values depicting greater significance. The possible substitutes for P value are also discussed to enable a rational interpretation of results of new discoveries.
RET in non-small cell lung carcinoma
Authors: Nathany Shrinidhi , Diwan Himanshi , Batra Ullas
Published: January 2022

The advent of stratified medicine and tailored therapies has caused non-small cell lung cancer (NSCLC) to become a subject of keen interest, with an emphasis on comprehensive genomic testing for driver mutations and biomarkers. The rearranged during transfection (RET) gene rearrangement has been observed in 1%–2% of all NSCLCs. In this edition of the biomarker series, we have reviewed the available literature on RET and its biology, along with the clinical features and therapeutic options for RET-rearranged NSCLC. For the purpose of this review, we performed a detailed search of the PubMed, Scopus, and My Cancer Genome databases using the keywords “RET,” “NSCLC,” “pralsetinib,” and “selpercatinib.” We included 42 articles in the final review. Studies suggest that RET rearrangement has emerged as a new biomarker of interest in NSCLC owing to the development and approval of selective RET inhibitors. Newer trials comparing RET inhibitors with chemotherapy and immune checkpoint inhibitors are underway. However, more studies are required to lucidly explain the underlying biology, including newer mechanisms of resistance to selective RET inhibitors, to guide drug development in future.
Clinical profile and outcomes of malignant melanoma in patients from an Indian institute
Authors: Shishak Sorun , Mittal Abhenil , Aswar Harshal , Pandey Rambha , Kalra Kaushal , Gupta Aarushi , Barwad Adarsh , Dhamija Ekta , Shamim Shamim Ahmed , Aggarwal Aditi , Kaliyath Soorej Balan , Rastogi Sameer
Published: January 2022

Background:

The profile of patients with malignant melanoma in Asian countries is distinctly disparate from that of those in Western countries. Malignant melanoma is a rare malignancy with scarce literature from India.

Objectives:

We aimed to describe the clinical profiles and outcomes of Indian patients with advanced malignant melanoma.

Materials and Methods:

We retrospectively analyzed the data of consecutive patients with malignant melanoma who presented to the bone and soft tissue sarcoma clinic at the All India Institute of Medical Sciences, New Delhi, between January 2016 and March 2019. Our primary endpoint was to evaluate the clinical profile of the patients and the patterns of treatment. The secondary endpoints were response rate, progression-free survival (PFS), and overall survival (OS).

Results:

We included 93 patients in the cohort, with a median age of 53 years (range, 25–85). The majority of patients were men (61.3%); almost half had an Eastern Cooperative Oncology Group performance status of 2 or greater. Most (89.2%) patients had metastases at presentation. The most common primary sites were anorectal (24.7%), acral (24.7%), ocular (17.2%), head and neck (15.1%), and thigh (9.7%). The median number of metastatic sites at presentation was 2, with the most common sites of metastases being the lymph nodes (57%), lung (48.3%), liver (35.5%), and bone (25.8%). BRAF V600E mutation was present in three out of four tested patients, while c-KIT mutation was present in two out of seven tested patients. At a median follow-up of 18 months, the median PFS was 2 months (95% confidence interval, 1.2–2.7 months) and median OS was 7 months.

Conclusion:

Acral/mucosal melanoma is the most common melanoma among Indians and has poor outcomes. Limited access of patients with melanoma to standard-of-care therapeutic options remains an important issue in a resource-constrained country like India.
Recurrent, Persistent Pneumothorax in a Neonate
Authors: Hegde Shalini G. , Mohanty Suravi , Balachander Bharathi , Shubha A. M.
Published: January 2022

Newborns, especially preterms, have a higher risk of developing pneumothorax. We report a 33-week preemie who presented with recurrent, persistent right pneumothorax, which failed to resolve with standard treatment. The child underwent surgical removal of a suspect nonexpanding upper lobe of the right lung with clinical improvement. Histopathology was atypical but nearly consistent with congenital pulmonary airway malformation (CPAM). This report highlights the clinicopathological discordance noted and aims to draw an embryological explanation toward the atypical histomorphology of CPAM in preemies.
Prophylactic use of donut-shaped cushion to reduce sacral pressure injuries during open heart surgery
Authors: Heo Min Hee , Kim Ji Yeon , Park Beom Il , Lee Sang Il , Kim Kyung-Tae , Park Jang Su , Choe Won Joo , Kim Jun Hyun
Published: January 2022

Background:

Pressure injuries are likely to develop in the operating room due to the high temperature and humidity underneath the patients. This study was designed to reduce sacral pressure injuries using donut-shaped cushions on patients undergoing open heart surgery in a supine position for more than three hours.

Materials and Methods:

Patients undergoing open heart surgery for more than three hours were randomly allocated. Depending on the allocation, either the donut-shaped cushion (donut group) or hydrophilic foam dressing (control group) was applied before draping. Patients were evaluated for the development of pressure injuries, National Pressure Ulcer Advisory Panel (NPUAP) stage, and injury size immediately after surgery, 48 hours, and seven days after surgery.

Results:

Forty-five patients were enrolled in this study. Twenty-two were assigned to the donut group and 23 were assigned to the control group. Three patients developed pressure injuries of NPUAP stage I or higher. All injuries occurred in the control group, but there was no statistically significant difference (P = 0.083).

Conclusions:

Patients who underwent cardiac surgery for more than three hours and used a donut-shaped cushion did not develop pressure injuries, although no statistical difference was noted. Specific preventative measures in the operating room may play a crucial role in preventing pressure injuries, and further research should be pursued.
Adductor canal catheter block after total knee arthroplasty in patients with severe osteoarthritis and limited mobility. A single center study in Riyadh, Saudi Arabia
Authors: Alturki Abdullah , Alsheikh Khalid , Aldeghaither Sarah A. , Alsebayel Firas M. , Alazzam Saleh , Alhandi Ali A.
Published: January 2022

Purpose:

Total knee arthroplasty (TKA) is one of the most performed procedures. Postoperative pain control is an important factor for the improvement of patient's quality of life. The aim of this study is to report pain control results and functional outcome scores associated with adductor canal blockade (ACB) usage post-TKA.

Methods:

A prospective case series study of patients who underwent TKA for degenerative osteoarthritis with ACB postoperatively from 2018 to 2019 in a single center in Saudi Arabia, Riyadh. Assessment of functional outcome scores and pain level were measured preoperatively and postoperatively respectively using Knee injury and Osteoarthritis Outcome Score (KOOS) and the Visual Analog Scale (VAS).

Results:

Average KOOS score preoperatively for all 5 domains showed a marked improvement at 3 months compared to preoperative values. Pain score postoperatively was measured at 12, 24, and 48 h with an average of 0.7, 1.2, and 0.6 out of 10 on the VAS scale, respectively. The incidence of associated common side effects with the use of analgesic use was included as an add-on in the postoperative questionnaire.

Conclusion:

In conclusion, by comparing preoperative and postoperative pain levels and functional outcome scores, our study showed a significant pain control and improved functional outcome scores following TKA using ACB.
Ultrasonographic evaluation of incidence of diaphragmatic paralysis following different volumes of supraclavicular brachial plexus block- A prospective randomized double blinded study
Authors: Johnson J. Edward , Daniel Shabila
Published: January 2022

Background:

Ipsilateral diaphragmatic paralysis occurs following supraclavicular blocks such as interscalene blocks, supposedly attributable to the backward diffusion of the local anesthetic (LA) inside the neural sheath. Hence, we have made an attempt to assess diaphragmatic paralysis with ultrasonogram (US) following different volumes of supraclavicular brachial plexus blocks (SCB).

Aim:

To compare the incidence of diaphragmatic paralysis with different volumes of supraclavicular brachial plexus block using ultrasonogram.

Methods:

Sixty patients with American Society of Anesthesiologists (ASA) Physical Status I and II were randomized to receive 20, 25, or 30 mL of 0.375% bupivacaine in a double-blinded fashion, and supraclavicular block was performed using ultrasound guidance in an in-plane technique. Diaphragmatic excursion and velocity were studied using a curvilinear 3.5 MHz transducer before and 20 min after giving the block.

Results:

The incidence of reduction in diaphragmatic excursion and velocity in the group receiving 30 mL was 45% and 45%, respectively, which was higher, whereas it was 47.5% and 32.5% in the 25 mL group and 40% and 25% in the 20 mL group, respectively, which were still lower. Pre- and post-block data were studied using T-test, Kruskal–Wallis test, and Mann–Whitney U test. The probability of reduction in diaphragmatic excursion and velocity in each group was <0.05, which was statistically significant.

Conclusion:

Our results suggest that there is a greater risk of inadvertent phrenic nerve blockade even in supraclavicular brachial plexus block. The resulting hemidiaphragmatic paralysis is volume dependent, and the overall incidence is higher at greater volumes. Hence, caution is required against compromised perioperative lung function in patients with preexisting cardiorespiratory dysfunction.
Analisis Penerimaan Sistem Informasi Laboratorium di Perguruan Tinggi Vokasi
Authors: Agung Raharjo Muhammad , Octavianie Adhitya , Fadhilah Nugrah Andi
Published: January 2022

Politeknik Penerbangan Makassar memiliki sejumlah fasilitas laboratorium dengan tingkat utilitas yang tinggi, dimana ketersedian aspek sarana dan prasarana sangat penting pada laboratorium. Penggunaan sistem informasi dibutuhkan untuk dapat mengelola fasilitas dengan lebih baik, oleh karena itu sebelum sistem ini diterapkan secara penuh, maka diperlukan analisa terkait perilaku pengguna sistem informasi, sehingga dapat diterima oleh pengguna sistem informasi di Politeknik Penerbangan Makassar. Pendekatan yang digunakan dalam penelitian ini dengan Technology Acceptance Model (TAM) terdiri dari persepsi manfaat (perceived usefulness) dan persepsi kemudahan penggunaan (perceived easy of use), dengan menggunakan pengukuran skala Guttman. Hasil penelitian ini diperoleh bahwa faktor kegunaan persepsian (perceived usefulness) sebagian besar tenaga pendidik maupun taruna-taruni memberikan persepsi positif dalam menggunakan sistem informasi laboratorium, sedangkan faktor kemudahan penggunaan (perceived easy of use) memberikan persepsi negative terhadap sistem informasi laboratorium karena belum sepenuhnya bisa digunakan oleh pendidik dan taruna-taruni disebabkan belum disediakannya fitur yang dapat diakses untuk memudahkan dalam penggunaan laboratorium
Kesesuaian Uji Antigen Capture Enzyme Linked Immunosorbant Assay dan Nested Multiplex Polymerase Chain Reaction untuk Diagnosis Rutin Bovine Viral Diarrhea
Authors: Irianingsih Sri Handayani , Waluyati Dessie Eri , Sari Desi Puspita , Wuryastuty Hastari
Published: January 2022

Abstract

Bovine Viral Diarrhea (BVD) is one of the main causes of impaired productivity and reproduction of cows. Antigen capture Elisa (ACE) is one of the serological technique that is sensitive, reliable and used regularly for detecting persistent BVD infection individually which simpler than  multiplex nested PCR. The aim of this study was to determine the agreement between ACE and multiplex nested PCR as a routine laboratory diagnostic technique to detect the presence of BVD infection. A total of 128 cow serum samples consisting of 63 positive and 65 negative samples based on ACE were used in this study. The samples were collected from active and passive surveillance in dairy and beef cattle conducted by Balai Besar Veteriner (BBVet) Wates. The serum samples were then tested molecularly using multiplex nested PCR against BVD. The result showed 48 out of 63  BVDV-1 positive samples were found positive BVD antigen whereas 57 of 65  BVDV-1 negative samples were negative using multiplex nested PCR, . The agreement value between the two different assays based on statistic analysis using Kappa method was 0.64 and classified a good one. The result concluded that the ACE BVD assay was equally suitable as routine diagnosis to determine BVD infected cattle in the farm.

Keywords: Antigen capture ELISA; Bovine viral diarrhea; Kappa; Multiplex nested PCR.

 

Abstrak

Bovine Viral Diarrhea (BVD) merupakan salah satu penyebab gangguan produktivitas dan reproduksi sapi. Antigen capture ELISA (ACE) merupakan salah satu teknik serologis yang sensitif, dapat diandalkan dan digunakan secara teratur untuk mendeteksi infeksi BVD persisten secara individual yang lebih sederhana daripada multiplex nested PCR. Tujuan penelitian ini adalah untuk mengetahui kesesuaian antara uji ACE dan multiplex nested PCR sebagai teknik diagnostik laboratorium rutin untuk mendeteksi adanya infeksi BVD. Sebanyak 128 sampel serum sapi yang terdiri dari 63 sampel positif dan 65 negatif berdasarkan ACE BVDV Antigen Test Kit/Serum Plus (Idexx®) digunakan dalam kajian ini. Sampel serum sapi merupakan koleksi dari surveilans aktif dan pasif pada sapi perah dan potong yang dilakukan Balai Besar Veteriner (BBVet) Wates. Sampel serum kemudian diuji secara molekuler menggunakan multiplex nested PCR terhadap BVD. Hasil penelitian menunjukkan bahwa dengan teknik multiplex nested PCR, 48 dari 63 sampel positif BVDV-1 ditemukan positif untuk antigen BVD sedangkan 57 dari 65 sampel negatif BVDV-1 negatif untuk antigen BVD. Analisis statitik berdasarkan perhitungan metoda Kappa menunjukkan nilai kesesuaian antara dua uji sebesar 0,64 dan tergolong bagus. Hasil penelitian menunjukkan kesimpulan bahwa uji ACE BVD sesuai sebagai diagnosis rutin untuk menentukan ternak yang terinfeksi BVD di peternakan.

Kata kunci: Antigen capture ELISA; Bovine viral diarrhea; Kappa; Multiplex nested PCR.
Penggunaan Cairan Ekstrak Isi Gizzard dan Duodenum Ayam pada Pengukuran Kecernaan In Vitro Daun Turi (Sesbania grandiflora)
Authors: Mulyono Ali Mursyid Wahyu , Yani Sri Sukar , Awanis Jizan Fahmia Al
Published: January 2022

Abstract

The aim of this study was to examine the use of Gizzard Contents Extracts (GCE) and Duodenum Contents Extracts (DCE) of Chicken on In Vitro digestibility measurements of Turi Leaves (Sesbania grandiflora). The study was designed using a One-way Classification of Completely Randomized Design (CRD) with 4 treatments. Each treatment was repeated three times. Types of treatment in the form of using GCE and DCE, including: (1) control treatments (without GCE or DCE), (2) GCE, (3) DCE, and (4) a mixture of GCE and DCE. The observed variables were Coefficient of Dry Matter Digestibility (CDMD), Coefficient of Organic Matter Digestibility (COMD), and Coefficient of Soluble Protein Digestibility (CSPD). The results showed that the addition of GCE, DCE, and a mixture of GCE and DCE could not increase the CDMD, COMD, and CSPD of Turi Leaves compared to the control treatment.

Keywords: Duodenal contents extract; Gizzard content extract; In vitro digestibility; Turi leaves.

 

Abstrak

Penelitian bertujuan untuk mengkaji penggunaan cairan ekstrak isi gizzard (CEIZ) dan duodenum (CEID) ayam pada pengukuran kecernaan in vitro daun turi. Penelitian dirancang menggunakan Rancangan Acak Lengkap (RAL) pola searah dengan 4 perlakuan. Masing-masing perlakuan diulang tiga kali. Macam perlakuan berupa penggunaan penggunaan CEIZ dan CEID ayam, meliputi perlakuan kontrol (tanpa CEIZ maupun CEID), CEIZ, CEID, dan campuran CEIZ dan CEID. Variabel pengamatan berupa koefisien cerna bahan kering (KCBK), koefisien cerna bahan organic (KCBO), dan koefisien cerna protein terlarut (KCPT). Hasil penelitian menunjukkan bahwa perlakuan penambahan cairan ekstrak isi gizzard, duodenum dan campuran keduanya tidak dapat meningkatkan KCBK, KCBO, dan KCPT daun turi dibandingkan dengan perlakuan control.

Kata kunci: Cairan ekstrak isi duodenum; Cairan ekstrak isi gizzard;  Daun turi; Kecernaan in vitro.
Reflexões sobre currículo escolar
Authors: Santos Cleci Helena Ludwig dos
Published: January 2022

O artigo busca refletir sobre o currículo no conjunto de conhecimentos educacionais e a influência do mesmo no espaço escolar. O objetivo da pesquisa é desenvolver uma análise e uma reflexão crítica socializadora em que todos os segmentos construam uma história cultural, social e educacional. O objetivo específico é compreender a importância e a abrangência do currículo escolar na aprendizagem significativa dos discentes. A metodologia é de natureza qualitativa desenvolvida através de pesquisa bibliográfica. É possível compreender que o currículo escolar é um eixo significativo para alcançar as metas estabelecidas pela escola, sendo que este deve ser repensado pelo coletivo, a fim de a escola possa obter um ensino aprendizagem de modo construtivo. O desafio a ser enfrentado é a falta de coletividade e consciência critica na elaboração da proposta curricular.
Contribuições pedagógicas das práticas lúdicas no desenvolvimento infantil
Authors: Brandoni Roseli da Cruz
Published: January 2022

Este artigo discorre acerca das contribuições da ludicidade para o processo de aprendizagem do aluno na etapa da Educação Infantil e apresenta resultados de uma pesquisa qualitativa, cujo objetivo tratou de discutir sobre a importância do brincar no processo de desenvolvimento da criança, visando à construção do conhecimento e aprendizagem por meio de brincadeiras, jogos e brinquedos. Pois, é no brincar que surge a interação entre a espontaneidade e a criatividade com a progressiva aceitação das regras sociais e morais por parte do educando. É brincando que a criança se humaniza, aprendendo a conciliar de forma afetiva a afirmação de si mesma à criação de vínculos afetivos duradouros. Realizou-se um levantamento frente às possibilidades que a brincadeira desencadeia na construção e reconstrução dos conhecimentos, desse modo, contribuindo para elencar as contribuições da ludicidade no processo de ensino-aprendizagem. Desse modo, o lúdico permite novas maneiras de ensinar, associado a fatores que podem tornar o ensino mais atrativo e contribuir com uma educação de maior qualidade, capaz de ir ao encontro dos interesses essenciais à criança. Na intenção de viabilizar o desenvolvimento dessa pesquisa, utilizou-se como referências bibliográficas Vygotsky (1984); Kishimoto (2003); Base Nacional Comum Curricular (2017) e ainda outros autores que versam sobre a temática da ludicidade na infância.
Avant-propos : La distinction par l’alimentation : Manger pour être (Moyen Âge et Siècle d’Or hispaniques)
Authors: ROUMIER Julia
Published: January 2022

Donnant une nouvelle impulsion à l’étude historique du comportement alimentaire et à l’anthropologie de l’alimentation, Jean Louis Flandrin fait de la « distinction par le goût » une clé d’interprétation majeure des pratiques du passé révélant la dimension politique des arts de la gastronomie. Cela permet en premier lieu de dépasser les visions simplistes d’un Moyen Âge rustre, aux manières grossières, essentiellement consommateur de viandes rôties et utilisant les épices sans finesse. Cette gastronomie est en réalité une rhétorique élaborée et ritualisée et ces aspects alimentaires de l’ostentation sont bien des signes de supériorité, au sens de ce que J.P. Daloz (2010) nomme des symboles matériels ou « prestigious goods », une spectacularisation de la domination à travers une expression sensorielle mais aussi une source de plaisir physique codifiée dans un environnement courtisan : la table est bien un espace politique.
Non sans raison le roi Alphonse X, dans le Titre VII des Siete partidas, dédié à l’éducation, offre une place importante à des lois régissant le comportement à table, lieu de plaisir, de réunion et de discussion. La nourriture est au cœur des relations humaines et, en particulier à la cour et dans les sphères du pouvoir se nouent autour de la table les jeux de représentations structurant la hiérarchie sociale et consacrant la légitimité des puissants.
El Banquete real tardogótico: un modelo ritual en las cortes ibéricas a fines de la Edad Media
Authors: NOGALES RINCÓN David
Published: January 2022

El presente trabajo busca estudiar el modelo del banquete real tardogótico en el ámbito de la península ibérica, con el objetivo de poner de relieve sus ejes estéticos e ideológicos. Para ello, se atenderá a campos de análisis como los manjares del banquete, el ritual del servicio de mesa, los modos de exhibición de la vajilla, los actos teatrales asociados al banquete o el uso del espacio ceremonial. Asimismo, se estudiarán las posibles vías de intercambio cultural que contribuyeron a la definición de este modelo ritual a lo largo de las décadas finales de la Edad Media en la Península.
Ability, Inequality and Post-Pandemic Schools
Authors: Bradbury Alice
Published: January 2022

Alice Bradbury discusses how the meritocracy myth reinforces educational inequalities and analyses how the recent educational developments of datafication and neuroscience might challenge how we classify and label children as we rebuild a post-pandemic schooling system.
Body Count
Authors: Hamourtziadou Lily
Published: January 2022

Lily Hamourtziadou's important analysis of the scale and causes of civilian deaths in Iraq since the US-led coalition's 2003 invasion sheds new light on the War on Terror. From early fighting to the departure and return of troops and the rise of ISIS, she tracks the cost of conflict and constructs an insightful human security approach to war.
Taller vocacional sin sesgo para elección de la carrera profesional en estudiantes de 4to y 5to de secundaria Piura
Authors: Concha-Lima Noemí , Briones-Mendoza Mario Napoleón
Published: January 2022

Es frecuente encontrar jóvenes estudiantes de educación superior, quienes siguen una carrera y en el camino se desaniman, y muchos de ellos aceptan que eligieron dicha carrera por diferentes motivos, pero no por convicción personal. En este sentido la presente investigación tuvo como objetivo general determinar la influencia de un Taller vocacional sin sesgo, para la elección de la carrera profesional en estudiantes del 4to y 5to de secundaria, en Piura-Perú. El estudio fue de tipo cuantitativo, diseño cuasi experimental con dos Grupos (control y experimental). La población fue 60 estudiantes de instituciones educativas Piura. Se utilizaron dos cuestionarios para conocer intereses y actitudes vocacionales, dio como resultado influencia significativa en diferencia de las Medias, Según la T de Student, al obtener un p valor de 0,000 < 0,05, el grupo experimental en el pretest obtuvo una  Media de 47.00 y en Post test fue de 39.43 lo que hace evidente la diferencia de medias, así mismo la diferencia en el Post test de los dos grupos comparados tenemos una potencia de 1-β = 1.0 y un efecto de d=2.28, ambos mayores al tamaño tabular de 0.80. Estos resultados llevaron a concluir que el taller aplicado al grupo experimental fue eficaz y  se concluye que, si existe influencia significativa del Taller Vocacional sin sesgo para la elección de la carrera profesional de estudiantes de secundaria de institución educativa Villa María Cieneguillo Centro Piura, 2021.
Prenatal Diagnosis and Postnatal View Of Omphalocele-Exstrophy Vesicalis-Imperforate Anus-Spinal Defects Complex
Authors: ŞEKER Erdal , SÜT Hasan , ÜMİT Coşkun , KOÇER Mustafa , KOÇ Acar
Published: January 2022

The omphalocele-exstrophy vesicalis-imperforated anus-spinal defects (OEIS) complex is a rare variant of the bladder
exstrophy epispadias complex and multisystem anomalies involving the gastrointestinal, genitourinary, and skeletal
systems. The number of patients who have OEIS complex and do not terminate their pregnancy is small. We present the
prenatal and postnatal radiological images of a patient diagnosed with OEIS at the twentieth gestational week.
PENGARUH DISIPLIN KERJA DAN PENDIDIKAN PELATIHAN TERHADAP KINERJA PEGAWAI DI KECAMATAN TAPOS KOTA DEPOK
Authors: Koto Deni Indra Purnama
Published: January 2022

Aset organisasi paling penting yang harus dimiliki oleh suatu organisasi dan sangat diperhatikan oleh manajemen adalah asset manusia dari organisasi tersebut.Organisasi dikelola dan terdiri atas orang-orang,para karyawannya, tanpa orang-orang maka organisasi tidak bakal ada.Kinerja pegawai sampai saat ini belum sesuai harapan, karena masih terjadi kesenjangan antara yang berkinerja sangat baik dengan yang berkinerja hanya sebatas standar minimal yang ditentukan.Disiplin kerja yang belum optimal demikian pula pendidikan pelatihan yang belum efektif.Banyak variabel yang mempengaruhi kinerja pegawai, sesuai hipotesa ada pengaruh antara disiplinkerja dan pendidikan pelatihan terhadap kinerja pegawai secara parsial maupun simultan.Sesuai penelitian ternyata teruji ada Pengaruh Disiplin Kerja Pegawai dan Pendidikan Pelatihan terhadap Kinerja Pegawai di , Kecamatan TAPOS , KOTA DEPOK secara parsial maupun simultan dengan persamaan regresi berganda, Yaitu : Y = 27,158 + 0,351X1 + 0,644X2 dan koefisien determinasi berganda sebesar 75,10% dengan rincian, sebagai berikut:1.       Disiplin kerja pegawai mempengaruhi kinerja pegawai, sebesar 35,10%.2.       Pendidikan pelatihan pegawai mempengaruhi kinerja pegawai sebesar 64,40%.3.       Disiplin kerja pegawai dan pendidikan pelatihan pegawai secara simultan (bersama) mempengaruhi kinerja pegawai sebesar 75,10%.Pengaruh pendidikan pelatihan lebih dominan dibandingkan dengan disiplin kerja pegawai namun apabila dikerjakan secara simultan akan bersinergi karena pengaruhnya meningkat terhadap kinerja pegawai menjadi sebesar 75,10%.Untuk meningkatkan kinerja pegawai maka manajemen harus memperhatikan dan meningkatkan, antara lain sebagai berikut:1.       Disiplin pegawai harus ditingkatkan dengan cara memberikan sangsi tegas bagi pegawai yang melanggar.2.         Manajemen harus melaksanakan kegiatan pendidikan pelatihan secara rutin dan terencana sesuai kebutuhan organisasi dan pegawai.
ANALISIS RASIO PROFITABILITAS SEBAGAI ALAT UNTUK MENILAI KINERJA KEUANGAN PADA PT. ACE HARDWARE INDONESIA Tbk (AHI)
Authors: Astuti Indri , Safitri Eka
Published: January 2022

This research aimed to examine the effect of Return on Assets (ROA), Return on Equity (ROE) and Net Profit Margin (NPM) on the financial performance of PT. Ace Hardware Indonesia Tbk (AHI) which were listed on Indonesia Stock Exchange. While, the data were secondary, in which taken from company’s financial statement 2014-2017. Moreover, the research was quantitative. In addition, the data analysis technique used descriptive statistics and inferential analysis with SPSS 25. From the data result, it concluded Return on Assets, Return on Equity, Net Profit Margin, and financial performance had good average score. Likewise, from the inferential analysis, it showed classical assumption test of all variables had fulfilled the assumption and there was no violence. As well as from the proper test model, it showed regression model was properly used. In brief, from the hypothesis result, it concluded Return on Assets and Return on Equity had significant effect on the financial performance. On the other hand, Net Profit Margin had insignificant effect on the financial performance.