bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the Level of Awareness among Pregnant Women Regarding Antenatal Care Services at the Selected Upazila Hospital in Bangladesh
Authors: Parag Deb Dulal Dey , Alam, Ummul Khair , Noor Irfan Nowroze , Barman Nishat , Hossain Md. Sazzad , Alo Antara Paul , Irani Susmita Podder , Tammi Noshin Nahid
Published: May 2024

Background: Antenatal care (ANC) is a critical component of maternal and child health care, focusing on the medical and psychological well-being of pregnant women from conception to the onset of labor. Therefore, awareness among pregnant women regarding antenatal care services is crucial. Aim of the study: The aim of this study was to assess the level of awareness among pregnant women regarding Antenatal Care Services. Methods: A descriptive cross-sectional study was carried out at 3 upazillas of Kishorganj district to assess the level of satisfaction of pregnant women regarding antenatal care at selected upazilla health complex during covid-19 pandemic. A total of 163 pregnant women were interviewed from 3 upazilla health complex, Kishorganj were included in this study. Result: Most pregnant women visiting the upazilla health complex were aged 18-23 (54.6%), with a mean age of 23.38 years (SD ±3.659). Information about the complex's services was primarily received from healthcare personnel (70.6%). The majority found the complex consistently open (97.5%), providing satisfactory care (89%). Most respondents (81%) received all necessary medicines, and 77.3% confirmed the availability of medical instruments. Awareness of antenatal care services was high, majority knew about pregnancy registration and check-ups. Among the respondents 51.5% were good aware and nearly half of respondents (48.5%) were poor aware about ANC related services provided from upazilla health complex. Conclusion: The findings of the current study indicate a strong awareness of antenatal care services among the majority of respondents.
Effect of drain placement on postoperative radiology following burrhole drainage of chronic subdural hematoma
Authors: Altaf Imran , Muhammad Rizwan Sarwar
Published: May 2024

Objective:
The effect of drain placement on postoperative radiology following burrhole drainage of chronic subdural hematoma (ChSDH) is a topic that has been rarely addressed in literature. The present study was designed to study the effects of postoperative drain placement on different radiological parameters following ChSDH evacuation.
Materials & Methods
We studied the data of 117 patients operated with burrhole drainage of ChSDH and divided the patients into two groups. In the first group a postoperative subdural drain had been placed while the second was the no drainage group. The pre- and postoperative CT brain of the patients were analyzed and the change in the hematoma width and midline shift was noted.
Results:
In the drainage group 12 (18.2%) patients had recurrence. In the no drainage group also 12 (23.5%) patiens had recurrence. The difference in recurrence wasn’t significant (p=0.4775). The mean change in the width of the hematoma was 0.95 ± 0.37 mm in the drainage group, while in the no drainage group this was 0.51 ± 0.37 mm. This difference was very significant (p < 0.0000001). The mean change in the midline shift was 0.51 ± 0.21 mm in the drainage group, while in the no drainage group this was 0.26 ± 0.22 mm and this difference again was very significant (p < 0.0000001).
Conclusion
The placement of a subdural drain following burrhole evacuation of ChSDH leads to significantly decreased postoperative hematoma width and mass effect providing the radiological corroboration for drain placement.
Intraoperative Computed Tomography Scanner-Guided Junctional Zone Spinal Surgery in Fluoroscopic Limitation Zone-An Early Experience
Authors: Usman Ahmad Kamboh  , Adeel Rauf  , Muhammad Usama Saleem  , Mehreen Mehboob  , Mehwish Manzoor  , Sana Jamal  , Manzoor Ahmad
Published: May 2024

Objective:  Confirmation of the level for surgery at the junctional zones of the spine is associated with unique difficulties. C-Arm has its limitations in these areas. The use of intraoperative CT scan with navigation greatly helps in the surgery at junctional zones. These junctional zones include the craniocervical junction, cervico-dorsal junction, and sacroiliac junction. In 2019, we installed an Airo Brain Lab 32-slice MDCT in our facility and researched to evaluate its advantages in junctional zone fluoroscopy-restricted spine operations.
Material and Methods:  We performed 20 complex surgeries in all these 3 junctional zones with the use of an intraoperative computed tomography scanner. 3 patients had craniovertebral junction fixation under intra-op CT while 6 had lateral mass fixation. 3 patients had cervicodorsal junction fixation and 4 patients had lumbosacral fixation.
Results:  2 out of 3patients with cervicodorsal fixation had correction of screws trajectory after usage of intra-op CT and 1 patient with lumbosacral fixation. All patients were discharged home with neurology better or the same as compared to pre-op. status while 13 patients had a favorable outcome.
Conclusion:  Intraoperative computed tomography scanner is opening new horizons for complex spinal surgeries.
Keywords:  , ,, .
A Spectrum of Spina Bifida: A Study of Neurosurgery Department of DHQ Teaching Hospital, Gomal Medical College, DI Khan
Authors: Shahid Nawaz  , Muhammad Usman  , Sarah Rehman  , Aneeta Ghazal  , Naseer Hassan  , Naeem-ul-Haq
Published: May 2024

Objective:  To pin down the spectrum of spina bifida in infants.
Materials & Methods:  This prospective cohort study was conducted at the Neurosurgery Department, DHQ teaching hospital, Gomal Medical College, D.I Khan, Pakistan, from July 2021 to July 2022. A total of 100 diagnosed infants of spina bifida of either gender, who were undergoing surgery were included in the study. Demographics like; gender, name, age, cousin marriage, region, type of spina bifida (meningocele or meningomyelocele), associated with hydrocephalus, and width of the defect were noticed. Post-operatively the maximum follow-up was of 1 month for noticing the outcome and complications.
Results:  Of a total number of 100 infants, 76 patients were male, while 24 were female. The mean age of the patients was 913.625 days. The majority of the children (n = 59) were having myelomeningocele. The lumbosacral spine was the most common location (n = 88) for myelomeningocele/meningocele. Post-operatively, there was the development of hydrocephalus in 12 patients.
Conclusion:  The majority patients of with spina bifida were males. Meningomyelocele and lumbosacral location were the commonest findings. Furthermore, the lumbosacral location of the spina bifida and myelomeningocele were most commonly associated with the development of postoperative hydrocephalus.
Frequency of Misplacement of Percutaneously Placed Pedicle Screws in Thoracolumbar Fractures
Authors: Syed Ahmad Faizan  , Ajlan Ali  , Tariq Imran  , Zubair Mustafa  , Muhammad Aqeel Natt  , Asif Bashir
Published: May 2024

of thoracolumbar fractures.
Material and Methods:  A descriptive case series was conducted at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore. The study comprised all individuals who had minimally invasive percutaneously implanted thoracic or lumbar pedicle screws placed. CT scans were conducted on the patient 24 hours after surgery as part of their usual post-operative care to capture axial pictures to find Pedicular cortical breaches in any direction.
Results:  Mean age of the patients was 32 years. 82.7% were male whereas 17.3% were females. We found that the frequency of misplacement was 10.9% in the management of thoracolumbar fractures. 110 patients received 600 pedicle screws placed percutaneously. Of these, 534 screws (89.1%) were ideally placed inside the pedicle. 7% showed minor pedicle penetration, 3.6% showed moderate pedicle penetration and only 0.3% showed severe penetration. Out of misplaced screws (10.9%), 7.3% of patients were between 15 – 40 years, and 3.6% were between 41 – 50 years. Out of misplaced screws (10.9%), 9.7% were male patients and 1.3% were female patients. For thoracic injury, 4.5% of patients suffered from misplaced screws, and for lumbar injury, 6.5% of patients were observed for misplaced screws (p-value: 0.008).
Conclusion:  The frequency of misplacement was 10.9% in the management of thoracolumbar fractures. The misplacement rate of the percutaneously placed screw is low. Therefore, we concluded that the percutaneously placed screw is safe to use.
Significance of Correlation Between Spinopelvic Parameters in Patients of Chronic Low Back Pain
Authors: Waqas Noor Chughtai  , Tahira Fatima  , Azhar Rashid  , Muhammad Adeel Razzaque  , Manqoosh-ur-Rehman  , Tahira Fatima  , Muhammad Asad Ullah
Published: May 2024

Objective:  To determine the significance of the correlation between spinopelvic parameters in patients with chronic low back pain.
Materials and Methods:  129 patients with chronic low back pain of a minimum of 03 months duration were included in our study from September 2020 to February 2023. Sagittal standing spinopelvic radiographs were done on all patients. Various spinopelvic measurements were done including PI, PT, LLA, SLA L1 – L3, SLA L3 – S1, LSA, SHA, and SIA. Pearson correlation was used to determine the correlation coefficient.
Results:  The mean age was 36.45 ± 9.54 years. Males were 59 and females 70. Mean and SD of spine pelvic measures were LLA = 57.32 ± 12.45, SLA L1-L3 = 15.31 ± 3.75, SLA L3 – S1 = 42.46 ± 8.34, LSA = 8.94 ± 4.72, SHA = 38.10 ± 7.94, SIA = 52.42 ± 6.84, PT = 11.21 ± 5.83, PI = 48.72 ± 8.90. PI has a significant positive correlation with LLA ( r= 0.492 and p-value < 0.001).
Conclusion:  PI and LLA are important spinopelvic parameters and have significant correlation with other spinopelvic parameters and derangement of one of them can affect the overall spine sagittal balance resulting in chronic low back pain.
Re-Operation Rates after Burr-Hole Aspiration of Brain Abscess
Authors: Sehrish Altaf  , Farrukh Javeed  , Iram Bokhari  , Anas Ahmed  , Raheel Gohar  , Mohammad Daniyal Mumtaz
Published: May 2024

Objectives:  To determine the re-operation rates after burr-hole aspiration of brain abscess.
Materials & Methods:  The cross-sectional study was conducted from August 2022 to January 2023 at Jinnah Postgraduate Medical Centre (JPMC). A single burr-hole aspiration was used to treat a total of 64 cerebral abscess patients. Demographics, clinical presentation, predisposing variables, abscess location on imaging, and clinical outcomes were examined in medical records.
Results:  The study included 64 patients with 60.9% males and 39.1% females. Patients most commonly presented with headache (90.6%) and fever (81.2%) with the majority of patients (92.1%) aged less than 30 years. The commonest source of infection was congenital heart disease (29.6%) in both aspiration and re-aspirations (46.6%). The parietal region was the most common location in both aspiration (32.8%) and re-aspiration (40%) of abscesses with the majority (40%) of re-aspirations done in the 3rd postoperative month.
Conclusion:  Single burr-hole aspiration is a safe and effective method for the management of brain abscesses. It is a less invasive procedure and is associated with minimal complications. The learning curve is short and safely be performed by neurosurgeons in training.
Keywords:  Brain abscess, Burr-hole aspiration, Re-aspiration, Infection, Meningitis.
Factors Predicting Outcome of Surgically Treated Acute Subdural Hematoma
Authors: Shah Khalid  , Amer Zaman  , Waseefullah  , Faiza  , Abdul Majid khan
Published: May 2024

Objective:  The study aimed to evaluate operative mortality and prognosis factors in posttraumatic acute subdural hematoma patients.
Material & Methods:  A prospective cross-sectional study was done in the Department of Neurosurgery, Ayub Teaching Hospital Abbottabad. 82 patients operated for Acute Subdural Hematoma were included in the study. Variables that influence the outcome were recorded. The outcome was measured in terms of mortality.
Results:  Of 82 patients operated on, 61 were male, and 21 were female. 51 were <40 old years, 21 were aged 41-60, and 7 were over 60. The most common cause is fall from height (47.6%). Cerebral contusion is often associated (28%). Overall mortality: 39.2%. Male mortality: 29.2%, female: 9.7%. Surgery >4 hours post-injury had higher mortality (18.2%) vs. <4 hours (8.5%). 14/43 GCS <8 patients survived, with no deaths when GCS >12. Pupillary abnormalities had higher mortality (31.9%) vs. normal pupils (7.3%). No deaths with hematoma thickness <10mm and only 1 survived with a thickness >16mm. 25/29 died with midline shift >11mm.
Conclusion:  Prognostic factors for surgically treated traumatic acute subdural hematoma include GCS at presentation, pupils, hematoma thickness, midline shift, and time to surgery. Better outcomes associated with GCS>9, normal pupils, hematoma width <1.5cm, midline shift <1cm, and surgery within 4 hours.
Association of Hydrocephalus in Children with an Encephalocele
Authors: Habib Sagheer , Bokhari Iram , Ahmed Tanveer , Akbar Rabail , Gohar Raheel , Ahmed Anas
Published: May 2024

Objectives: To describe the association between the occipital encephaloceles with hydrocephalus and how to improve the outcome of patient.
Methodology: Our Prospective study collected records of fifty patients diagnosed with posterior encephaloceles. Data were collected on the gender, location of the encephalocele, presence of neural tissue , dandy walker, microcephaly and hydrocephalus.
Results: Twenty-nine females and twenty-one males were present. Over half of the lesions were supratorcular, while the remaining eight (16%) were torcular and the remaining seventeen (34%) were infratorcular. Primary encephalocele repair were done at an average of 9 days (range 2.5–120 days). In twenty-five of the instances, a diagnosis of hydrocephalus was made. Twenty-four patients had a ventriculo-peritoneal shunt implanted. The average age of implantation of VP shunt was only 1.2 months (range 0.3–9 months). One patient underwent an endoscopic third ventriculostomy with good results. Hydrocephalus was related with Dandy-Walker and ventriculomegaly before encephalocele surgery was performed (p values 0.01 and 0.05, respectively). For hydrocephalus therapy, 
Conclusions: Patients born with encephaloceles frequently suffer from hydrocephalus (50%). This is especially true in cases where the patient also has Dandy-Walker syndrome, CMIII malformation, or pre-existing ventriculomegaly. The severity of large encephaloceles is a limiting factor for the development of hydrocephalus when connected with torcular types and microcephaly.
Assessment of Neuropsychological Impairment among Individuals with a History of Head Trauma – A Case-Control Analysis
Authors: Khan Javeria , Shamim Zainab , Tehreem Khudija , Abbas Kiran , Ahmed Moiz , Javeed Farrukh
Published: May 2024

Objective:  To determine the frequency of different neuropsychological impairments in traumatic head injury survivors compared to those without a history of head trauma.
Materials and Methods:  A case-control study was done in Karachi, Pakistan, during February 2023 and March 2023, with participants aged 18 and above, of both genders, with or without a history of head trauma forming the case and control groups, respectively. Individuals with a history of head trauma or congenital neurological impairment were not included. Screening tools included the ESS, UNS, GAD-7 scale, and PHQ-9.
Results:  A total of 303 participants were enrolled, out of these 128 (42.2%) were in the case group and 175 (57.8%) were in the control group. The most common source of head injury was Road Traffic Accidents (53.9%, n = 69). 143 (63.8%) out of 224 males had a positive history of head trauma in their lifetime, making the male gender more susceptible. The majority who had a history of head trauma lie in the age group < 21 years (52.6%, n = 110). No significant association was found between the interpretations of screening scales and history of head trauma.
Conclusion:  Traumatic head injuries and their long-term consequences can predispose a person to experience any cognitive impairment in their life. However, in this study, we could not find significant neuropsychiatric deficits in patients with a history of head trauma. Therefore, it is crucial to conduct further large-scale, multi-center, and controlled studies to explore the cognitive and psychological impairment associated with head trauma.
Head Injury Due to Fall from Heights in Pediatric Population of a Middle Resource Country
Authors: Iqbal ahamad  , Muhammad Hassan Raza  , Adnan Qasim  , Eram Abbas  , Sheraz Ahmad  , Muhammad Kashif Chishti
Published: May 2024

Objective:  One of the serious concerns for public health is unintentional injuries. Falls rank as the second most common cause of unintentional injury deaths globally, after injuries sustained in transportation accidents. The study's goals were to check the mechanisms and severity of the head injury from falls among children.
Materials and Methods:  A non-randomized retrospective study was conducted and children aged 0 – 12 years (n = 228) undergoing cranial CT guidance for head injury were enrolled. All patients were treated under the supervision of the neurosurgery department. Detailed radiological evaluation was done and recorded on specialized proforma.
Results:  Among the enrolled patients, mild head injury was noted in 49.1% of children while moderate head injury was noted among 40.4% of children. A total of 72 (31.6%) patients had skull fractures, of which 12 (5.3%) had a thin underlying subdural hemorrhage. Four cases of extradural hemorrhage complicated a skull fracture, and eight cases of isolated Subdural hemorrhage (SDH) were observed without a skull fracture. Of those 48 (21%), radiologically evident diffuse axonal injuries were present, and each of them included high-force injury mechanisms.
Conclusion:  When children sustain minor trauma, skull fractures, and focal SDH are rather common, although most of the time there are no long-term neurological effects. On the other hand, patients with an equally severe cause of injury were the only ones who experienced diffuse brain injury with significant neurological disability that followed.
Efficacy Of Short-Segment Transpedicular Fixation for Thoracolumbar Fractures in Terms of Improvement in Neurological Status
Authors: Ahmad Sajjad , Mian Iftikhar ul haq
Published: May 2024

Objective:  To determine the efficacy of short-segment transpedicular fixation for thoracolumbar fractures in terms of improvement in neurological status.
Materials and Methods:  A prospective observational research was conducted at Bacha Khan Medical Complex, Swabi, Section of Neurosurgery. Patients having traumatic thoracolumbar fractures with neurological deficits were subjected to short-segment transpedicular fixation and evaluated for post-operative improvement in neurological status at a 6-month follow-up.
Results:  48 patients participated in the study. Mean age was 35.69±8.22 years and 60.4% were males. History of falls was the most common mechanism responsible for spinal injury i.e. 56.3%. D12 vertebra was fractured in 43.8% of patients. The leading type of fracture was, AO type B in 37.5% of patients. 23 (47.9%) of the patients showed one or more grade improvements in their neurological status on the ASIA scale at 6-month follow-up. Surgical site infection was the common postoperative complication (8.3%).
Conclusion:  Short-segment transpedicular fixation is an effective procedure for traumatic thoracolumbar fractures in terms of improvement in neurological status.
Anterior Lateral Approach for Anterior Decompression, Corpectomy, and Fixation with Webb Morley Procedure for Dorsolumbar Spinal Fracture
Authors: Aurangzeb Kalhoro  , Vashdev Khimani  , Muhammad Hamid Ali  , Mubarak Hussain  , Mahesh Kumar Luhano
Published: May 2024

Objective:  Efficacy of anterolateral approach Webb Morley procedure in a low-income country.
Materials & Methods:  A descriptive study was conducted at the Department of Neurosurgery, Liaquat University of Medical and Health Sciences, Jamshoro. Patients of any gender presented to us with dorsal or lumber injury, plus a presentation on X-ray / MRI as spinal fractures having bone fragments pressing the cord, especially from the anterior side were included in the study. The assessed tool was based on clinical findings of Frankel's grading.
Results:  We had 64 patients, who had dorsal and lumber fractures and went through the procedure of Webb Morley 43 were male and 31 were female patients The male-to-female ratio was 2:1 and the mean age was 39±3 yrs. with a median age was 42.5yrs. Fall (n = 34, 53.12%) was the common cause, road traffic accidents were (n = 16, 25%), fall of heavy objects (n = 11, 17.18%), and assault (n = 03, 4.68%).
Conclusion:  Based on the current study of our Centre the anterior lateral approach for lower dorsal and upper lumber level with decompression and fixation with Webb-Morley procedure is a safe and effective method.
Usage Frequency, Barriers, And Effectiveness of Functional Electrical Stimulation as An Intervention for Stroke Patients
Authors: Mehreen Niaz  , Fozia Baloch  , Asma Bilal  , Prem Sagar  , Nadeem Ahmed Memon
Published: May 2024

Objective:  To determine the frequency of Functional Electrical Stimulation (FES) use in stroke rehabilitation and to identify the barriers and effectiveness of its usage as an intervention for stroke patients.
Materials & Methods:  This prospective observational study was performed in different clinics and hospitals in Hyderabad. Physical therapists actively practicing in healthcare facilities within Hyderabad, with a minimum of one year of clinical experience in stroke rehabilitation of either gender were included. A questionnaire was structured to collect data on the usage frequency, perceived barriers, and effectiveness related to the utilization of FES in stroke rehabilitation.
Results:  Most of the participants were using FES frequently and sometimes for shoulder subluxation, improving arm function, enhancing walking function, improving muscle strength and endurance, addressing hypertonia and spasticity, and improving sensation. Respondents when asked about having sufficient time to apply FES, lack of evidence justifying FES use, and regards to workplace support most of the cases >50% agreed strongly agreed, while <50% of study subjects’ believed that does not provide advantages for individuals having a chronic stroke. FES utilization among healthcare professionals in stroke patient rehabilitation, highlighting its potential benefits in improving arm function, shoulder subluxation, walking performance, and hemiplegic shoulder pain. However, there were no significant barriers identified.
Conclusion:  There was a significant use of FES by physical therapists in Hyderabad to address various aspects of stroke rehabilitation. The study overall highlights its potential for improving arm function, preventing shoulder subluxation, enhancing walking, and reducing hemiplegic shoulder pain, without significant identified barriers.
Results of Comparison of Burr Hole Evacuation Versus Surgical Excision of Multiloculated Subdural Empyema
Authors: Rana Zubair Mahmood  , Mukhtiar Ahmed Lakho  , Muhammad Ajmal Khan Ayaz  , Shahzeb Ahmad  , Usama Mansoor  , Yasin Khan  , Muhammad Anwar
Published: May 2024

Objectives:  We studied the results of results of comparison of burr hole evacuation versus surgical excision of multiloculated subdural empyema.
Material and Methods:  A total of 40 patients were admitted with the disease. We will analyze the results of 20 patients. It is a comparative observational study of 20 patients treated at the Punjab Institute of Neurosciences (PINS), Lahore. Presenting complaints of patients were fever, vomiting, headache, fits, etc.
Results:  The age range was 15 – 60 years. The mean age was 36 years, Medical management was given to 20 patients (100%) for 3 weeks. All patients were advised to take complete bed rest for 3 weeks. Anti-epileptic, Mannitol, antibiotics, and painkillers were the medications that were given. In this study, we will focus on the 20 patients treated surgically, and the analysis of 20 patients will be presented in complete detail. Our 10 (50%) patients were managed by burr hole evacuation of multiloculated subdural empyema. Surgical excision was done in 10 (50%) patients with multiloculated subdural empyema. Burr hole evacuation was done in patients who were old and unfit for surgery. Recurrence occurred in 5 (25%) patients who underwent management with burr hole evacuation and 1 (5%) patient in the excision group.
Conclusion:  The results of surgical excision of multiloculated subdural empyema are better than burr hole evacuation if the patient is for surgical excision.
Improved Outcomes in the First 72 Days of Medical Management of Cerebral Abscess in Post-Traumatic Patients
Authors: Rana Zubair Mahmood  , Mukhtiar Ahmed Lakho  , Muhammad Ajmal Khan Ayaz  , Shahzeb Ahmad  , Usama Mansoor  , . Yasin Khan  , Muhammad Anwar
Published: May 2024

Objective:  We studied the results of medical and surgical management of cerebral abscesses in post-traumatic patients after road traffic accidents (RTA).
Material and Methods:  It is a comparative observational study of 40 patients in Lahore General Hospital/Punjab Institute of Neurosciences (PINS), Lahore. Our patients were presented with fever, vomiting, headache, fits, etc.
Results:  The age range of our patients was 15-60 years. The mean age of our patients was 40 years, we gave medical management along with bed rest to all 40 patients (100%) for 3 weeks. Anti-epileptic, mannitol, antibiotics, and painkillers were the medication that was given. Our 30 (75%) patients who were managed medically, had headaches, and vomiting which did not resolve for we had to operate on the patients. Surgical management was done in 10 (25%) patients. Surgical excision was done in 9 (97%) patients and burr hole evacuation was done in 1 (3%) patients. All patients who recovered from medical management are those who were treated within 1st week after the occurrence of cerebral abscess.
Conclusion:  The results of medical management of cerebral abscess are better than surgical management if patients are treated during the first week after the occurrence of cerebral abscess. With good antibiotics etc.
ABORDAGEM CIRÚRGICA DAS MALFORMAÇÕES ARTERIOVENOSAS CEREBRAIS: ESTRATÉGIAS DE TRATAMENTO E RESULTADOS
Authors: Silva Aguinaldo Pereira da , Silva Eliana Marques Gomes da , Ramos Juliana Wandermurem Melo , Costa Evelyn Ramos da , Ortega Susanny Cristina da Silva , Teles Manuela Brandão Ferreira , Manganeli Ana Gabriela de Oliveira , Pereira Vitória da Costa , Assunção Leila Jane Brito , Oliveira Italo Aguiar de , Neto Luis Antônio Barbosa , Oliveira João Paulo Pacheco de , Giordani Frida Chaves
Published: May 2024

A abordagem cirúrgica das malformações arteriovenosas cerebrais é essencial para o tratamento dessas condições complexas. Essas anomalias vasculares intracranianas, caracterizadas por conexões anômalas entre artérias e veias, podem resultar em hemorragias cerebrais, convulsões e outros problemas neurológicos debilitantes. Objetivos: Revisar as   diversas estratégias de tratamento cirúrgico utilizadas para abordar as malformações arteriovenosas cerebrais. Materiais e Métodos: A coleta de dados, esta foi conduzida por meio dos bancos de dados: Scientific Electronic Library Online (SCIELO), PubMed, Literatura Latino-Americana do Caribe em Ciências da Saúde (LILACS). Foram consultados diversos tipos de publicações, incluindo artigos científicos, monografias e revistas, com o objetivo de obter informações relevantes sobre o tema. Resultados e Discussões: A eficácia e segurança das estratégias cirúrgicas para tratar malformações arteriovenosas cerebrais. Embora algumas abordagens tenham demonstrado alta taxa de sucesso na resolução das MAVs, outras foram associadas a menos complicações pós-operatórias. Destaca-se a importância da abordagem multidisciplinar e da necessidade de estudos adicionais para avaliar os desfechos a longo prazo. Em suma, os resultados e discussão destacam a necessidade de personalização do tratamento e colaboração interdisciplinar para otimizar os resultados clínicos. Conclusão: Em conclusão, este artigo revisou as estratégias cirúrgicas para o tratamento de malformações arteriovenosas cerebrais, destacando a diversidade de abordagens disponíveis e sua relevância clínica. É fundamental reconhecer a importância da personalização do tratamento com base nas características individuais de cada paciente e na colaboração interdisciplinar entre profissionais de saúde. Esperamos que este trabalho contribua para uma melhor compreensão e manejo dessas condições complexas, visando melhorar os resultados clínicos e a qualidade de vida dos pacientes afetados pelas malformações arteriovenosas cerebrais.
FORMULASI DAN UJI MUTU FISIK SEDIAAN GEL EKSTRAK BUNGA TELANG (Clitoria ternatea L.) SEBAGAI ANTISEPTIK TANGAN
Authors: Farhan Moh
Published: May 2024

Hands are one of the media for microbial growth, dirty hands become a breeding ground for microbes such as Staphylococcus aureus and Escherichia coli or other bacteria. How to maintain hand hygiene is to wash your hands with soap or use an antiseptic (hand sanitizer). Antiseptic preparations are substances that have been widely used to inhibit the growth and kill microorganisms that exist around the body surface, for example on the palms of the hands that often come into contact with the surface of an object. One of the natural ingredients that has the potential to be developed as a hand antiseptic is telang flower (Clitoria ternatea). This research will formulate antiseptic gel preparations from telang flower extract, and how to test the physical quality of antiseptic gel preparations from telang flower extract. The method used for the extraction process here uses the maceration method, to maintain the antimicrobial compounds contained in the telang flower, followed by testing the physical characteristics and quality of the telang flower gel preparation, including, Organoleptic Test, pH test, Viscosity test, Homogeneity test, Spreadability test, adhesion test. After testing the characteristics and physical quality of the gel preparations of telang flower extract, the results were quite optimal, namely with a pH value in the range of 4.26-4.41 according to skin pH, and for viscosity at a value of 64% - 33%, in accordance with the characteristics of a good gel. Telang flower extract can be made and formulated as an antiseptic hand gel preparation. Variations in the concentration of the extract used greatly affect the characteristics of the gel preparation, starting from pH, viscosity, adhesion, and dispersion. The higher the concentration of the extract used, the lower the viscosity value, and the lower the pH value. The pH value and viscosity value for all formulas were in accordance with the skin parameter criteria, namely 3.5-6.5. Based on research conducted, Formula 3 using a concentration of 0.5 has. the most optimal gel preparation
FORMULASI SEDIAAN SALEP KOMBINASI EKSTRAK ETANOL DAUN NANGKA (Artocarpus heterophyllus Lam.) DAN DAUN KERSEN (Muntingia calabura L.)TERHADAP PENYEMBUHAN LUKA TERBUKA PADA TIKUS JANTAN PUTIH TAHUN 2022
Authors: Sianipar Masria Phetheresia
Published: May 2024

Background: Wounds are damage to part of body tissue or damage to tissue components, where there are damaged or missing tissue substances. Jackfruit leaves (Artocarpus heterophyllus Lam.) contain secondary metabolites, namely, flavonoids, saponins and tannins. Flavonoids function as antibacterial and reduce inflammation in wounds. Saponins to trigger the formation of collagen. While the tannins function as an antibacterial.
Cherry leaves (Muntingia calabura L.) contain several active compounds such as flavonoids, saponins, and tannins. Compounds that function as anti-inflammatory are flavonoids. These compounds can accelerate wound healing because it has anti-inflammatory activity.
 Objective: to determine the concentration of the combination ointment of jackfruit leaf and cherry leaf ethanol extract in the form of an ointment that is most effective in healing open wounds. Method : Experimentally. Samples using jackfruit and cherry leaves were taken purposively, extracted by maceration using 96% ethanol as a solvent made in the form of a thick extract. Then the thick extract was made into an ointment with a ratio of 1:2, 2:1 and 2:2 as well as positive control (bacitracin ointment), negative control (ointment base). open wound for 14 days. Results: The results of the open wound healing study had the best effectiveness, namely bacitracin ointment (0 cm), a combination ointment of jackfruit leaf and cherry ethanol extract 2:2 (0.10 cm), 1:2 (0.25 cm) and 2 :1 (0.28 cm) then ointment base (0.55 cm). Conclusion : The preparation of ointment combination of jackfruit leaf ethanol extract and 2:2 cherry is more effective in the treatment of open wounds.
U UJI AKTIVITAS ANTIBAKTERI SEDIAAN GEL HAND SANITIZER SANITIZER BUNGA LAWANG (Illiacium verum Hook. f) pada BAKTERI Staphylococcus aureus & Escherichia coli
Authors: Marbun Novarianti
Published: May 2024

Some diseases caused by microorganisms on the hands are diarrhea, diphteria, boils, typhus and others. The bacteria that most often contaminate the skin of the hands are Staphylococcus aureus and Escheria coli, whose spreas most often transmitted from hand to hand. Bunga lawing are one of the medicinal plants that have been used in medicine. The purpose of this study was determine the antibacterial activity of gel hand essential oil sanitizer gel preparation (Illiacium verum Hook.f) to the growth of Staphylococcus aureus and Escheria coli bacteria compared to sanitizer Dettol gel hand. This was carried out with the experimental method. Essential oil of bunga lawing is extracted using a heat method, namely soxhletation. The antibacterial activity test in this study used the agar diffusion method (disc diffusion). The measurement of the diameter of the inhibited area formed were analyzed using a one-way ANOVA statistical test. The results of antibacterial activity of bunga lawang sanitizer hand have lower antibacterial activity gel hand sanitizer Dettol. In the diameter of Staphylococcus aureus bacteria the highest rate 0f hand flower sanitizer gel was 15,1 mm while the sanitizer gel hand wash 21,4 mm. In Escheria coli bacteria, the inhibitory diameter the sanitizer hand gel dettol was obtained at 20.1 mm, while the lawang hand sanitizer gel obtained the highest inhibition diameter of 13.1 mm. The results of data analysis using a one-way ANOVA statistical test showed a sig value p<0,05 so that there were significant differences between the gel hand to the inhibitory power of the growth of Staphylococcus aureus and Escheria coli bacteria.
linta meliala,roito yuliana UJI EFEKTIVITAS ANTIDIARE EKSTRAK ETANOL DAUN GAGATAN HARIMAU (Vitisgracilis BL) PADA TIKUS JANTAN PUTIH
Authors: Meliala Linta
Published: May 2024

Abstract
 
Diarrhea is the abnormal passage of loose or watery stools, with a frequency of more than three times a day. Diarrhea can be caused by bacteria. Gagatan Harimau leaves are known to have antibacterial properties. This research was conducted using an experimental method in the field of pharmacology at the Pharmacology Laboratory, Faculty of Pharmacy, Deli Husada Health Institute Delitua, using 25 rats induced with castor oil and divided into 5 treatment groups: negative control (1% CMC Na), positive control (Loperamide HCl), and treatment groups with ethanol extract of Gagatan Harimau leaves at doses of 50 mg/kg body weight (BW), 100 mg/kg BW, and 200 mg/kg BW. The sample used was Gagatan Harimau leaves (Vitis graillis BL), which were extracted by maceration using 96% ethanol as the solvent and concentrated using a rotary evaporator. The phytochemical screening results of Gagatan Harimau leaves showed the presence of flavonoids, saponins, alkaloids, and tannins. The results of the antidiarrheal effect test showed that the ethanol extract of Gagatan Harimau leaves at doses of 50, 100, and 200 mg/kg BW had antidiarrheal effects on male rats. The 200 mg/kg BW dose of ethanol extract showed the most effective antidiarrheal effect compared to the 50 and 100 mg/kg BW doses. The extract from Gagatan Harimau leaves (Vitis gracillis BL) exhibited antidiarrheal effects on male white rats induced with castor oil.
UJI AKTIVITAS ANTIBAKTERI SEDIAAN OBAT KUMUR KOMBINASI EKSTRAK ETANOL BUNGA CENGKEH (Syzygium aromaticum) DAN KULIT JERUK LEMON (Citrus limon) TERHADAP BAKTERI Streptococcus mutans DAN Streptococcus viridans PENYEBAB KARIES GIGI DAN BAU MULUT
Authors: Harahap Nina Irmayanti , Sari Rika Puspita , Harnis Zola Efa
Published: May 2024

Dental caries is an infectious disease and is a process of progressive demineralization of the hard tissue surface of the crown and tooth roots caused by bacterial activity. microorganisms in the mouth. Plaque inhibition can be done with anti-microbial agents to suppress the activity of bacteria such as Streptococcus mutans. Streptococcus mutans is a cariogenic bacterium that causes cavities and is the most dominant in dental plaque. These bacteria can convert sucrose into lactic acid so that it can cause tooth demineralization (Haniyah, 2019). Lemon peel (Citrus limon) is known as an antibacterial ingredient. To facilitate the use of lemon orange peel extract, namely by making it into mouthwash preparations. Mouthwash is a solution that contains antibacterial substances to reduce the number of microorganisms in the mouth, is used as an oral rinse, and is easy to use (Ririn et al., 2019). Research using clove flower extract and lemon peel as antibacterial against Streptococcus mutans and Streptococcus viridans made in mouthwash preparations is still limited, therefore researchers are interested in conducting further research with the title test of antibacterial activity in mouthwash preparations combination of clove flower ethanol extract (Syzygium aromaticum) and lemon peel (Citrus limon) in inhibiting the growth of Streptococcus mutans and Streptococus viridans bacteria that cause bad breath can be formulated into mouthwash preparations and meet the evaluation test requirements for mouthwash preparations and the average diameter of the largest inhibition zone is 12, 31 mm for Streptococcus mutans at a concentration of 2%:0.5% and for Streptococcus viridans at a concentration of 2%:0.5%, namely 11.31.
FORMULASI SEDIAAN HAIR TONIC EKSTRAK ETANOL DAUN TEH HIJAU (Camellia sinensis L.) SEBAGAI PENUMBUH RAMBUT TERHADAP KELINCI JANTAN (Oryctolagus cuniculus)
Authors: Sembiring Pintata
Published: May 2024

Background: hair loss is less or more hair than normal, with or without visible thinning. Green tea leaf minoxidil, whixh contains flavonoid compounds that may prevent hair loss, can be used to treat hair loss. Objective: this study aims to confirm whether green tea leaf ethanol extract can be used as a hair restorer that meets the requidments of physical stability, and to investigate the efficacy of green tea leaf extract hair restorer compared with minoxidil on hair growth purpose. Methods: This study used an experimental method that was macerated using 96% ethanol as a solvent.  The formula was made into 3 concentrations, namely 2.5%; 5%; 7.5% compared with the drug minoxidil as a positive control. The three formulas were first evaluated to meet the requirements for hair tonic stability, then the hair effectiveness test was carried out with the test animal being a male rabbit.  Results: the group that had the highest effectiveness on hair growth in rabbits was minoxidil which had an average value on the 7th, 14th and 21st days of 4.9 ;  6.3 ;  7.9 followed by the third formula which has a concentration of 7.5% as much as 4.5;  5.2 ;  6.5. While the negative control which was only applied with a hair tonic base only had hair growth 1,4; 1,9 ; 2,3. Conclusion: The preparation of hair tonic formula 1 to formula 3 met the requirements for physical stability, namely, pH test, viscosity test and organoleptic test.  The preparation of hair tonic ethanol extract of green tea leaves (Camellia sinensis L.) showed that the 7.5% concentration was more effective in accelerating hair growth compared to formulas 1 and 2, and also showed that the 7.5% concentration had almost the same effectiveness as minoxidil (positive control).
HUBUNGAN PENGETAHUAN DAN SIKAP MASYARAKAT KECAMATAN CAKUNG JAKARTA TIMUR TERHADAP PENGGUNAAN DAN RESISTENSI ANTIBIOTIK
Authors: Rusdi Numlil Khaira , Hastuti Septianita Hastuti , Maifitrianti Maifitrianti , Nurhasnah Nurhasnah , Azizah Rahma Nur
Published: May 2024

Antibiotic resistance is one of the serious problems that are being faced today. Low levels of knowledge and poor public attitudes about antibiotic use can trigger resistance. This study aims to determine the level of knowledge, attitudes, and relationships between the level of knowledge and attitudes of the community about antibiotic use and resistance in Cakung District, East Jakarta for the July-August 2023 period. The design of this study was descriptive with cross sectional method. The sampling technique uses purposive sampling. The source of data in this study is primary data in the form of knowledge questionnaires and attitudes about antibiotics. Knowledge is categorized with high and low, while attitude is categorized with positive and negative. The results showed that as many as 400 respondents met the inclusion and exclusion criteria.  The characteristics of public knowledge about antibiotics showed that 65.3% of respondents had high knowledge and 34.7% had low knowledge. As many as 61.0% of respondents had a positive attitude and 39% had a negative attitude towards the use of antibiotics and resistance. The results of the bivariate analysis showed that there was a significant relationship between the level of knowledge and people's attitudes towards antibiotic use and resistance (P<0.000). The higher the level of knowledge of the community, the more positive the attitude of the community towards the wise use of antibiotics.
EDUKASI KESEHATAN PENYEBAB DEMAM BERDARAH DENGUE DI DESA JATI KESUMA, KECAMATAN NAMORAMBE, KABUPATEN DELI SERDANG
Authors: Silalahi Novrika , Ginting Sulastri Br , Malau Pitto Pratiwi , Tinambunan Tedty Rohaya , Tampubolon Elmina , Purba Bahtera David
Published: May 2024

Hamlet II, Jati Kesuma Village, Namborambe District, the dominant livelihood of its residents are casual daily laborers. A discussion was carried out on 5 diseases which were prioritized into 1 problem by considering aspects of the emergency of the problem, the size of the problem, the extent of disease distribution, the speed of spread using the Pan American Health Organization (PAHO) method, using a score of 1 – 10 and scoring using a matrix, it was found Dengue Hemorrhagic Fever. A community service program with counseling was carried out in Dusun II, Jati Kesuma Village, one meeting on March 6 2024 with 34 people attending, with the result of increasing understanding of the counseling material starting from a comprehensive understanding of the symptoms of dengue fever, ways to prevent it and the subsequent effects of dengue sufferers. or as much as 85% experienced an increase. And three main factors were found, namely that many people still collect water without using bucket lids, hamlet residents rarely drain or clean water reservoirs and landfills which are still not optimal, resulting in a buildup of rubbish in the residences of hamlet residents.
 
Dusun II Desa Jati Kesuma Kecamatan Namborambe dominan mata pencaharian warganya buruh harian lepas. Dilakukan diskusi 5 penyakit yang diprioritaskan menjadi 1 masalah dengan mempertimbangkan aspek – aspek kegawatan masalah, besarnya masalah, luasnya distribusi penyakit, kecepatan penyebaran dengan menggunakan metode Pan American Health Organization (PAHO), dengan menggunakan skor 1 – 10 dan penilaiannya dengan matriks, maka ditemukan penyakit Demam Berdarah Dengue. Dilakukan program pengabdian masyarakat dengan penyuluhan di Dusun II Desa Jati Kesuma satu kali pertemuan di 06 Maret 2024 dengan jumlah peserta penyuluhan 34 warga yang hadir, dengan hasil peningkatan pemahaman dari materi penyuluhan mulai dari pemahaman menyeluruh gejala DBD, carah mencegah dan efek lanjutan dari penderita DBD atau sebanyak 85 % mengalami peningkatan. Dan ditemukan tiga faktor utama penyebab nya yaitu masih banyak melakukan penampungan air tanpa menggunakan tutup ember, warga dusun jarang menguras atau membersihkan tempat penampungan air dan TPA yang masih belum optimal sehingga terjadi penumpukan sampah di kediaman warga dusun
ICMS Ecológico como instrumento de política ambiental: um estudo comparativo entre estados do Sul e Centro-Oeste
Authors: Kubeneck Simone , Treichel Helen , Kroth Darlan Christiano
Published: May 2024

O aumento das atividades econômicas requerentes de recursos naturais culminou em uma série de consequências ao meio ambiente. Diante desse cenário, a criação de políticas voltadas ao meio ambiente se fez necessária. No Brasil a inserção de políticas ambientais se iniciou em 1981 com a criação da Política Nacional do Meio Ambiente e se intensificou ainda mais com a nova Constituição Federal de 1988, a qual garante o direito ao meio ambiente ecologicamente equilibrado e sua preservação para as presentes e futuras gerações, tornando a tributação ambiental possível e apta para seu uso em políticas públicas. Nesse contexto, e devido à restrição quanto ao uso da terra para atividades econômicas, teve-se a criação do ICMS Ecológico como forma de compensar os municípios que possuíam áreas de conservação de uso restrito. Tendo em vista esse contexto, este estudo visa à realização de uma revisão integrativa do ICMS Ecológico desde sua implantação. Além disso, apresenta a realização de um estudo de caso sobre a atual situação dos estados da região Sul e Centro-Oeste do País, quanto à implantação dessa política. Como resultados, observou-se a efetividade da política em questão nos estados, entretanto algumas melhorias na redação da lei são necessárias em alguns casos.
Ações de sustentabilidade 4.0 em uma empresa de energia: uma proposta de modelo de decisão multicritério
Authors: Gomes Poliana Carneiro , Santos Bruna Keila Macieira , Tavares Kleber Jose Tenorio , Melo Fagner José Coutinho de , Pinto Pablo Aurélio Lacerda de Almeida
Published: May 2024

Entender quais medidas precisam ser tomadas para a organização caminhar à sustentabilidade 4.0 é um trabalho complexo, mas compreender em que ordem os projetos relacionados a sustentabilidade 4.0 devem ser implementados é uma atividade ainda mais árdua. Desta maneira, o presente artigo possui como objetivo propor um modelo de decisão multicritério para elencar a ordem de prioridade das ações de sustentabilidade 4.0 numa empresa de geração e transmissão de energia utilizando o método de sobreclassificação PROMETHEE II. Foram elencados 8 projetos que impactam diretamente no alcance da sustentabilidade 4.0. Os resultados demonstraram que a aplicação do método de decisão torna mais clara a visão das alternativas para com os critérios estabelecidos e mais embasado o processo de decisão, contribuindo para a definição de prioridades. Análises de sensibilidade foram realizadas para confirmar a eficácia do modelo proposto. O estudo contribui para apoiar uma ampla rede de fornecedores de serviços como também gerar insights para técnicos e consultores que atuam em políticas internas e externas envolvendo as questões de sustentabilidade em empresas do ramo energético.