bluuebunny/crossref_metadata_2025 huggingface dataset:
Pelatihan Pembuatan Saos Tomat dan Pupuk Kompos sebagai Upaya Optimalisasi Komoditas Tomat Guna Membangun Ketahanan Ekonomi Desa Tolok Satu
Authors: Kantor Renatry , Ayu Widiyani I Dewa , Sumare Chika Wanda , Anjelina Preysi Wenas Glori , Victoria Londa Lolouren , Sandrina Sibara Syalomita , Tumengkol Josua , Lintogareng Anggretsya , Jordan Pangemanan Christian , Patinggi Christina , Ma'ati Carlene , Madi Eveline , Silvia Wewengkang Defny
Published: September 2024

Hasil produksi tomat yang melimpah pada panen raya merupakan masalah di Desa Tolok Satu karena dapat mengakibatkan harga tomat yang ada di tingkat petani menurun drastis, sehinggah hanya dibuang oleh masyarakat. Selain itu, keterlibatan generasi muda sangat kurang untuk mengolah buah tomat karena sifat tomat yang mudah rusak. Hal ini menjadi dasar pemikiran pelaksanaan kegiatan Program Penguatan Kapasitas Organisasi Kemahasiswaan Himpunan Mahasiswa Farmasi (PPK Ormawa Himafar) Fakultas MIPA Universitas Sam Ratulangi untuk membantu masyarakat Desa Tolok Satu menghadapi permasalahan over produksi tomat. Tujuan umum pelaksanaan kegiatan ini adalah meningkatkan kapasitas Ormawa Himafar dan meningkatkan soft skill Mahasiswa pelaksana PPK Ormawa, sedangkan tujuan khususnya adalah meningkatkan kemajuan Desa Tolok Satu terutama dalam mengoptimalkan produksi buah tomat unggulan desa. Hasil kegiatan yang diperoleh adalah: penguatan kapasitas organisasi kemahasiswaan Himafar UNSRAT, peningkatan softskill tim pelaksana PPK Ormawa Himafar UNSRAT, serta peningkatan kemajuan Desa Tolok Satu melalui produksi saus tomat dan pupuk kompos cair dari limbah tomat.
The failure of the militarised fight against ‘Galamsey’ in Ghana: A critical overview of the class and political dynamics
Authors: Aziabah Maxwell Akansina , Ayelazuno Jasper Abembia
Published: September 2024

This paper argues that the militarised fight against illegal artisanal small-scale mining (ASM) in Ghana—popularly known in Ghanaian parlance as ‘galamsey’—is neither class-neutral nor apolitical. It is politically opportunistic and elitist, class-wise. Drawing on a plurality of secondary sources—scholarly and grey literature, media, and internet sources – we present a critical overview of developments in the Ghanaian ASM sector, and the militarised fight against illegal operators.  Further, we delineate and clarify the politics and class dynamics that characterise the sector and the overall state-led fight against the phenomenon of ‘galamsey’. We predict that because these dynamics pivot on financial wherewithal and power, the militarised fight against ‘galamsey’ may hardly succeed and is thus always and forever bound to fail. Yet, its implications for the powerless subaltern classes are always appalling and deleterious, as they often lose their livelihoods in the fight, culminating in retarded community development.
Status of the fish stocks and fisheries of the main commercial fish species of Lake Ladoga in the XXI century
Authors: Leonov A. G. , Shurukhin A. S.
Published: September 2024

In the 21st century, there has been decrease in stocks and catches of aquatic biological resources in Lake Ladoga as well as a change in the structure of the fish population in the Lake, primarily due to changes in the trophic capacity of the reservoir. Smelt dominates in the commercial catches. Stocks and catches of autumn-spawning whitefish and lakecisco show obvious downward trend. Biological and commercial indicators of the pike-perch population are at a low level. Stocks of bream, roach and perch are in good condition.
Current state of sturgeon fish off the eastern coast of the Sea of Azov
Authors: Vilkova O. Yu. , Vasiov A. B.
Published: September 2024

The aim: the characteristics of sturgeon fish that make seasonal migrations to the near-shore zone of the Azov Sea.

Material — scientific monitoring of commercial fishing with stationary seines in the water area of the Sea of Azov adjacent to the Primorsko-Akhtarsk district in October 2022, 2023 and April 2023, 2024.

The results: Russian Sturgeon and Starry Sturgeon (Sevruga) were encountered in stationary seines from 50% to 100%, and the average catch of these species per facility was 1.3–7 sp./day in the autumn and spring periods, respectively. In the fall of 2022, the prevalence of Sevruga in bycatch was almost double — 63% of the total bycatch; in the spring and fall of 2023, 2024, the superiority was with Sturgeon — 63–83% of the bycatch. Size range of Sturgeon in 2022–2024 was from 22 to 148 cm; Sevruga — from 23 to 123 cm. The weight range of Sturgeon was from 0.1 to 30.0 kg, Sevruga — from 0.2 to 7.8 kg. The share of fish that reached the commercial length was on average 20.7% of Sturgeon and 36.6% of Sevruga. The age of the fish varied from fingerlings to 16+ for Sturgeon and up to 8+ for Sevruga. The average fullness coefficient of Russian Sturgeon in the autumn was 0.72; in spring, — 0.79; Sevruga: in the autumn of 2022 and 2023–0.45, in the spring of 2023–0.58. The state of Russian Sturgeon in the near-shore aggregations indicates the formation of its full-fledged mixed-age population in the Sea of Azov, that allows to expect its commercial fishing in the near future, on the background of the increasing its stock. The state of the Sevruga requires more in-depth research. A high fish fatness coefficient indicates their sufficient food supply.

Practical value: Observations of bycatch in stationary seines in the near-shore area of the sea are an important addition to the accounting trawl survey data for understanding the structure of the Russian Sturgeon population in the Azov Sea and practically the main source of information on the state of the Sevruga population.
Towards a method for determining the age of chum salmon
Authors: Elnikov A. N. , Zelennikov O. V.
Published: September 2024

The purpose of the work is to perform a quantitative comparative analysis of the structure and size of annual rings of chum salmon scales to prepare a methodological manual for determining age. The research material included scale preparations from 493 chum salmon producers of different ages, on which sclerites were counted and the diameter of annual rings was measured.

Methods used: comparative data analysis, descriptive statistics methods.

Results: it was found that the size of the scales, the size of each of the annual rings, as well as the number of sclerites in the annual rings of male and female chum salmon within each age group do not differ. The number of sclerites forming each annual ring, as well as the radius of the rings, varies significantly among different individuals. With age, as the length and mass of fish increase, the size of the scales naturally increases. Moreover, an acceleration in the growth rate is observed during the year preceding puberty. As a result, the number of sclerites in the last annual ring, as well as the size of this ring in fish that reach sexual maturity is always greater than in fish of the same age, but remaining in the sea to continue feeding.

Practical significance: the presented article is a scientific accompaniment of a methodological manual for the practical determination of the age of chum salmon by scales.
Technology of the fish abundance accounting in fish farming cages using hydroacoustic and software tools
Authors: Kuznetsov M. Yu. , Ubarchuk I. A. , Polyanichko V. I. , Shevtsov V.  I.
Published: September 2024

The purpose of the work: improvement of methods of fish number accounting in growing cages and reservoirs of fish farms using hydroacoustic tools and information technologies.

Methods used: solving the problem of non-contact (non-invasive) measurement of the number of fish in cages using the hydroacoustic echo integration method. Investigation of the reflective properties of fish using a calibrated scientific echo sounder with a split beam. Carrying out measurements with different numbers of fish in cage. Identification and analysis of factors affecting the accuracy of the echo integration estimation of the number of fishes in cage.

Novelty: the elements of novelty are the use of a scientific echo sounder with vertically oriented antenna and split beam to estimate the number of fishes in cages, the algorithm for calculating the number of fishes in cages by the echo integration method, the results of the study of reflective properties of Amur carp and identified optimal measurement conditions that allow hydroacoustic estimates of number with maximum accuracy.

Results: the dependences of target strength on the linear size of Amur carp are obtained. An algorithmic scheme for calculating the number of fishes in cages by the hydroacoustic echo integration method has been developed. Experiments were carried out with different numbers of fish in the cage. It is established that the main factors affecting the accuracy of the population estimate are the number of individuals in the cage and the daily distribution of fish. Measurements at night and at concentrations above the threshold (50 pcs./m2) can significantly bring the estimated and true numbers of fish in the cage closer and reduce the variability of density estimates.

Practical significance: solving the problem of remote measurement of the fish number in growing cages will allow farmers to optimize feed needs, which, in turn, will ensure rapid growth of fish without overfilling it and not polluting the reservoir.
Cervical Myelomalacia Diagnosed via Magnetic Resonance Imaging in a Patient With a Spinal Cord Stimulator for Complex Regional Pain Syndrome: A Case Report
Authors: Khan Mashfee
Published: October 2024

BACKGROUND: Neuromodulation is used to treat chronic pain, especially failed back surgery syndrome (FBSS) and complex regional pain syndrome (CPRS) type 1 and type 2. Until recently, neuromodulation had significant restrictions on magnetic resonance imaging (MRI) usage (4). Our patient provided Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant consent for the inclusion of his clinical information in this report. CASE REPORT: A 43-year-old man developed CPRS of his right upper extremity that was treated with an MRI-compatible high frequency spinal cord stimulator (SCS). Two years later, he presented with worsening neck and right upper extremity neuropathic pain. Due to the SCS device being MRI compatible, a cervical MRI was performed and showed severe cervical spinal stenosis at C3-C4 with myelomalacia and adjacent segment disease. The patient underwent posterior cervical decompression spine surgery, and urgent explantation of the SCS device. CONCLUSION: The patient maintained adequate strength and neurological function without any complications from myelomalacia. There was no delay in care in obtaining the MRI while the patient had the SCS device in place. In conclusion, the use of MRI-compatible devices should become the standard of care for implanting spinal cord stimulators. KEY WORDS: Spinal cord stimulator, complex regional pain syndrome, myelomalacia, magnetic resonance imaging
Scrambler Therapy for the Treatment of Pain and Sensory Symptoms in Corticobasal Syndrome: A Case Series
Authors: Wang Eric
Published: October 2024

BACKGROUND: Corticobasal syndrome (CBS) is a rare atypical parkinsonian disorder. Pain occurs in one-third of patients; current pain treatment options are often inadequate. Scrambler therapy (ST) is a noninvasive cutaneous method of neuromodulation that has shown success in other refractory neuropathic pain syndromes. CASE REPORT: We treated 3 patients with CBS with one to 3 40-minute sessions of ST, capturing the terminal arborization of the peripheral nerves within the affected painful dermatomes. All patients reported rapid and complete relief of their pain, with one patient having 4 months of ongoing relief, along with complete resolution of alien limb phenomenon. Another patient experienced 11 months of relief, with resumption of pain relief with retreatment after symptoms gradually returned. None have experienced complications or adverse effects to date. CONCLUSION: ST may represent a new noninvasive treatment for central pain associated with CBS. Further studies with longer follow-ups are warranted. KEY WORDS: Scrambler therapy, atypical parkinsonism, corticobasal syndrome, chronic pain, central pain
Femoroplasty as a Palliative Treatment Option for Pain Due to Metastasis and Fractures in Cancer Patients: A Case Report
Authors: Silva-Ortiz Victor
Published: October 2024

Background: Bone metastases are a frequent condition in cancer patients. They tend to manifest mainly in the long bones and spine, causing pain and reducing the patient’s quality of life. Percutaneous femoroplasty has been proposed to improve pain and bone stability in these patients by injecting polymethylmethacrylate (PMMA) into the affected areas. This report aims to demonstrate this technique’s benefits in stabilizing the bone and the hip joint by consolidating fractures due to bone metastases, alleviating cancer pain, and improving quality of life. Case Report: A 74-year-old female patient diagnosed with breast cancer and metastasis to the spine and femoral head, with severe oncological pain in the right hip region, is presented. In Tronzo’s classification, computed tomography showed a type I fracture in the right hip. Fluoroscopy-guided femoroplasty with bone cementation was performed, presenting significant pain relief in the short, medium, and long term and improved quality of life. Conclusion: Femoroplasty as a palliative technique to improve bone cancer pain is an important tool to consider when conservative management does not provide favorable results in pain and functionality, being a safe procedure for patients who cannot undergo major surgery. Key words: Bone pain, cancer pain, case report, femoroplasty, interventional pain
Intravenous Lidocaine Infusions Relieve Chronic Abdominal Pain: Case Report
Authors: Levin Danielle
Published: October 2024

Background: Endometriosis is a debilitating disease that presents with chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Treatment methods include surgery, no treatment, or medical therapy, commonly including nonsteroidal anti-inflammatory drugs, oral contraceptives, androgenic agents, progestins, and gonadotropin-releasing hormone analogs. Unfortunately, many of these patients have pelvic pain refractory to conventional medical treatment. Intravenous (IV) lidocaine infusions have been studied extensively for neuropathic pain, but there is no report available in regards to whether it could be beneficial for those afflicted with chronic pelvic pain secondary to endometriosis. Case Report: We would like to share the first report of a 37-year-old woman with chronic refractory abdominal pain from endometriosis continuously receiving greater than 3 weeks of pain relief from IV lidocaine infusions. Conclusions: This case report demonstrates that IV lidocaine infusions may be an effective and safe treatment option for those suffering from chronic abdominal pain from endometriosis. Key words: Lidocaine infusions, lidocaine, chronic pain, endometriosis, abdominal pain
Permanent Peripheral Nerve Stimulator Lead Adhesions Leading to Loss of Therapy and Difficult Extraction: A Case Report
Authors: Wu Hall , Evazyan Talin
Published: October 2024

Background: Over the past few decades, peripheral nerve stimulators (PNS) have become a useful option for treating refractory complex regional pain syndrome or neuralgia. Modern PNS are designed to prevent lead migration with tines or burs promoting tissue adhesion through fibrosis. However, few studies have examined the effect that this might have on nerve stimulation treatment. To our knowledge, this is the first documented case report describing how excessive scarring and fibrosis of leads may interfere with PNS therapy. Case Report: This paper describes a 67-year-old male patient who presented with peripheral neuropathy and peripheral vascular disease which was complicated by multiple surgical interventions and ischemia to his right lower extremity. He underwent permanent PNS treatment, but experienced treatment failure in both PNS leads - early on from lead migration, and later from significant adhesions leading to a difficult extraction. Conclusion: While tines and burs found on permanent PNS may prevent lead migration, the excessive scarring and fibrosis that they cause may interfere with PNS therapy by increasing impedance. More research is needed to better guide physicians in counseling and managing patients with refractory pain. Key words: Case report, difficult extraction, lead migration, peripheral nerve stimulator
Effects of Novel Dual Peripheral Nerve Stimulator Therapy: A Case Report
Authors: Wu Hall
Published: October 2024

BACKGROUND: Peripheral nerve stimulators (PNS) are currently used for refractory cases of neuralgia, and are associated with single manufacturer use. This is the first case report describing the novel scenario where a patient received 2 neuromodulation devices from 2 different manufacturers. CASE REPORT: We present a 32-year-old woman with spinal muscle atrophy type 2 who received a permanent PNS implant for chronic neuralgia. She experienced gradual treatment failure over 6 months, but continued to have pain relief with subsequent nerve blocks to the same nerves. She underwent semipermanent PNS placement to those same nerves. After the semipermanent PNS was removed, she experienced new, unexpected symptoms after trying to use her permanent PNS again. CONCLUSION: Instances of multiple PNS treating the same area in patients is likely going to be a recurring scenario. More research will be needed to document the potential effects that dual neuromodulation therapy may have. KEY WORDS: Case report, chronic pain, dual therapy, peripheral nerve stimulator
Celiac Plexus Blocks Prior to Median Arcuate Ligament Release Surgery: A Case Series
Authors: Habibi Behnum
Published: October 2024

BACKGROUND: Median arcuate ligament release (MALR) surgery is the most common procedure used to treat median arcuate ligament syndrome (MALS). Estimates of the success rate of this surgery range from 70-80%. Factors that affect the success of this procedure are not well understood. CASE REPORT: Nine patients with abdominal pain and a vascular ultrasound study suggestive of MALS underwent a celiac plexus block. All 9 continued to surgery and experienced ≥ 50% pain reduction in the upper abdomen postoperatively. Eight of these 9 patients had a positive celiac plexus block. One of 9 patients with a negative prognostic block experienced ≥ 50% pain reduction in the upper abdomen after surgery. CONCLUSIONS: These data suggest that the accuracy of prognostic celiac plexus blocks in predicting successful MALR surgery is 89%. This can be compared to estimates of the success rate of surgery without prognostic blocks (70-80%). KEY WORDS: Chronic abdominal pain, median arcuate ligament release surgery, median arcuate ligament syndrome, nerve block prognostic value, upper abdomen
PRP Therapy for the Treatment of Sacral Fracture and Coccydynia: A Case Report
Authors: Charliyan Gary
Published: October 2024

BACKGROUND: Platelet-rich plasma (PRP) therapy has shown promising results in promoting healing and reducing inflammation in musculoskeletal injuries. This case report highlights the successful use of PRP injection therapy in a 37-year-old woman pedestrian with a sacral fracture and coccydynia from a pedestrian-vehicle accident. CASE REPORT: The patient underwent traversing sacral S3 anterior cortex vertebral fracture and sacrococcygeal PRP injection under fluoroscopic guidance. PRP injection therapy led to significant improvement in tailbone pain, and subsequent injection led to further improvement in residual symptoms. Follow-up evaluations showed complete healing of the S3 fracture with good bony fusion and alignment. CONCLUSIONS: PRP injection therapy can be a safe and effective treatment option for bone fractures and injuries, especially those that may be difficult to manage with traditional approaches. As more clinical studies and case reports are conducted, the full potential of PRP in bone healing and regeneration may be further elucidated. KEY WORDS: Platelet-rich plasma, sacral fracture, coccydynia, case report, minimally invasive
Spontaneous Thoracic Dural Tear Presenting With Postural Headache: A Case Report
Authors: Greenspan Rebecca
Published: October 2024

BACKGROUND: Incidental dural tear (durotomy) is a known complication of many forms of spinal instrumentation. The majority of durotomy cases are due to a known traumatic force, such as an intentional durotomy during neuraxial anesthesia, or an unintentional tear during lumbar decompression surgery. However, spontaneous dural tears have occasionally been reported. CASE REPORT: We report a case of a 16-year-old woman with postural headaches who was found to have a spontaneous thoracic dural tear on magnetic resonance imaging. She underwent a successful fluoroscopic-guided epidural blood patch with resolution of symptoms. CONCLUSION: This case highlights the importance of considering spontaneous dural tears as a possible cause of postural headaches. KEY WORDS: Spontaneous dural tear, traumatic dural tear, idiopathic dural tear, durotomy, post-dural postural headache, epidural blood patch, headache, CSF leak, case report
Is Bipolar Dorsal Root Ganglion Pulsed Radiofrequency Effective in the Treatment of Postinjection Sciatic Nerve Neuropathy: Case Report
Authors: Yalcin Cigdem
Published: October 2024

BACKGROUND: Nerve injury is a common complication of intramuscular (im) injection and the sciatic nerve (SN) is the most frequently affected nerve. Pain management in neuropathic pain due to sciatic injury is challenging. CASE REPORT: A 66-year-old man admitted with neuropathic pain in his right leg. The pain commenced 6 years ago after an im injection into the right hip. CONCLUSIONS: Interventional treatment methods are not favored in the treatment of SN neuropathy subsequent to injection injury. However, bipolar pulsed radiofrequency treatment to L4-L5-S1 dorsal root ganglia may be an effective intervention in intractable sciatic neuropathy. KEY WORDS: Sciatic nerve, neuropathic pain, bipolar, pulsed radiofrequency, case report
Reversible Cerebral Vasoconstriction Syndrome Triggered by Contact With Water in a Swimmer
Authors: Gupta Deepali
Published: October 2024

BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a disorder characterized by segmental vasoconstriction of cerebral arteries, which leads to thunderclap-type headaches. These headaches peak in intensity within one minute and are often brought on by common triggers, such as contact with water, Valsalva maneuver, physical exertion, sexual activity, and use of vasoactive drugs, among others. CASE REPORT: A 40-year-old woman presented with a history of several episodes of severe headaches precipitated by swimming at work. After an inconclusive computed tomography, magnetic resonance imaging, and magnetic resonance angiography of the brain, transcranial Doppler revealed constriction of the left middle cerebral artery. Treatment with verapamil led to resolution of symptoms after 2 months. CONCLUSIONS: RCVS is likely underdiagnosed and carries with it a small risk for potentially fatal complications. Differentiating RCVS headaches from migraines, as well as other headache disorders, is essential, and the present case provides an opportunity to further clarify the delineation between them. KEY WORDS: Reversible cerebral vasoconstriction syndrome, RCVS, thunderclap headache, blood pressure surge, migraine
Peripheral Nerve Stimulation: A New Horizon for Traumatic Brachial Plexus Injury, A Case Report
Authors: Vangeison Christian
Published: October 2024

BACKGROUND: The management of traumatic brachial plexus injury is challenging. Treatment options consisting of physical therapy, pharmacologic therapy, and injection therapy often provide inadequate analgesia. Peripheral nerve stimulation (PNS) has emerged as a potential therapy for treatment of pain related to brachial plexus injury. CASE REPORT: We present a case of a 37-year-old man with painful ballistic trauma to multiple cords of the left brachial plexus refractory to medications and therapies. The patient was treated with a temporary 60-day PNS targeting the brachial plexus providing 90% improvement in pain intensity persisting 7 months postintervention. CONCLUSIONS: The case supports the efficacy of a temporary PNS system as a minimally invasive treatment option for brachial plexus injuries resulting in refractory neuropathic pain. Extended lead implantation of the temporary PNS device beyond the US Food and Drug Administration-approved 60 days may be of benefit to patients, although the potential risk of infection should be assessed and monitored. KEY WORDS: Traumatic brachial plexus injury, peripheral nerve stimulator, peripheral nerve stimulation, neuromodulation, neuropathic pain, case report
Peripheral Nerve Stimulation with High-Frequency Electromagnetic Coupling (HF-EMC) at the Ilioinguinal and the Superior Gluteal Nerve in the Treatment of Mononeuropathy
Authors: LaFleur J. Lance
Published: October 2024

BACKGROUND: Peripheral neuropathy is a difficult-to-treat condition. Peripheral nerve stimulation has shown to be an effective option but systems with an implantable battery are inappropriate due to its form factor. Complications and cosmetic concerns need to be considered when using conventional systems. Instead, externally powered peripheral nerve stimulation technology should be considered. CASE REPORT: A 62-year-old woman presented with pain in the right posterior superior iliac spine (PSIS) and the right upper buttock, radiating into the right posterior thigh. In addition, she began experiencing pain in the right lateral hip and the right inguinal crease and groin. The patient was diagnosed with right ilioinguinal and superior gluteal mononeuropathy and was offered a trial of an externally powered peripheral nerve stimulator. CONCLUSION: The patient had a successful trial and opted to have a permanent neurostimulator (electrode array and separate receiver). At 4 months after the permanent implant, the patient is reporting approximately 100% pain relief with improved quality of life. Peripheral nerve stimulation was a successful treatment option for a patient suffering from chronic, debilitating hip and groin pain. KEY WORDS: Groin, hip, ilioinguinal, mononeuropathy, peripheral nerve stimulation, PNS, posterior superior iliac spine, superior gluteal, thigh
Motor Blockade After Erector Spinae Plane Block for Lumbar Spinal Surgery: A Case Report
Authors: Kamyszek Reed
Published: October 2024

BACKGROUND: Regional anesthetic techniques, including the erector spinae plane block (ESPB), decrease pain scores while reducing opioid consumption. Given their high safety profile and analgesic efficacy, ESPBs offer an alternative to neuraxial anesthetic techniques for perioperative analgesia. CASE REPORT: Transient unilateral dense L3 motor weakness occurred as a complication of the ESPB performed intraoperatively for an L2-L5 laminectomy and L2-L3 discectomy at the L3 level. The motor weakness was concerning for spinal cord injury and confounded the postoperative neurologic examination. CONCLUSIONS: Lesson learnt from this case suggests the lumbar ESPB should be performed preoperatively in awake patients to avoid confounding physical exam findings in the postoperative anesthesia care unit; this also reduces the need for further emergent imaging and workup. During a lumbar ESPB, a local anesthetic should be deposited at the tip of the transverse process, and not breach the intertransversarii muscle and ligament to favor the dorsal spread and sparing of ventral rami motor fibers. KEY WORDS: Erector spinae plane block, ultrasound, regional anesthesia, spine surgery
Successful Treatment of Refractory Neuropathic Pain Following Axillary Dissection and Lipoma Resection Using Cervical and Thoracic Dorsal Root Ganglion Stimulation
Authors: Music Stephen
Published: October 2024

BACKGROUND: Neuropathy is a pain condition that is caused by an insult to the somatosensory system. Providing adequate management of neuropathic pain (NP) conditions can be challenging as the dis-ease may become progressively nonresponsive to conventional therapies. If conventional treatment options prove ineffective, cervical dorsal root ganglion (DRG) stimulation is a relatively effective, off-label-use therapy for NP, which requires expert cervical placement to be completed safely and effectively. The Neuromodulation Appropriateness Consensus Committee guidelines highlight safety features and general indications for DRG stimulation, which includes current on-label usage up to T10. Although this committee’s expert opinions stated that DRG is safe up to the C5 level, there is limited published efficacy and safety data at levels higher than T10. CASE REPORT: A 36-year-old woman with a significant medical history of anxiety developed intractable right upper extremity NP following an axillary dissection for a lipoma excision. De-spite conservative management, she presented with debilitating NP and severe right upper ex-tremity functional restrictions following the procedure. The patient underwent a C8-T1 DRG stimulation trial, which decreased her pain levels over 50%, and significantly increased her functional abilities. Right-sided C8-T1 permanent DRG leads were placed, which resulted in improved sleep, increased ability to use her right upper extremity, a 95% to 97% reduction in pain, and elimination of regularly scheduled analgesic medications. CONCLUSIONS: Cervical and high thoracic DRG was safe and successful in the treatment of right upper extremity NP in the upper dermatomal levels secondary to axillary dissection and lipoma resection. KEY WORDS: Cervical and high thoracic DRG, neuropathic pain, axillary dissection, lipoma re-section, neuromodulation, case report
Lumbar Sympathetic Block Causing Transient Paralysis in a Patient with Complex Regional Pain Syndrome: A Case Report
Authors: Rakesh Neal
Published: October 2024

BACKGROUND: Complex regional pain syndrome (CRPS) is a condition characterized by the development of spontaneous pain with features of allodynia; hyperalgesia; vasomotor, sudomotor, and trophic changes; as well as motor dysfunction. For lower extremity symptoms, the primary sympathetic intervention is the lumbar sympathetic block (LSB). There are several complications associated with the procedure including paraplegia, especially in the setting of neurolysis. CASE REPORT: In this case, we describe a patient who underwent a successful LSB with local anesthetic resulting in 4 days of transient lower extremity paraplegia and subsequent complete resolution. CONCLUSION: It is essential to understand that this is a potential complication of LSBs in patients with CRPS once all other explanations have been ruled out and that the symptoms will resolve with supportive care. KEY WORDS: Complex regional pain syndrome, lumbar sympathetic block, sympathetic mediated pain, transient paraplegia, case report
Botulinum Treatment Induced Dropped Head Syndrome in a Patient With Chronic Migraines and Multiple Sclerosis
Authors: Narula Sameer
Published: October 2024

BACKGROUND: Chronic migraine treatment typically is treated medically by use of medications, such as nonsteroidal anti-inflammatory drugs and triptans; however, for a subset of patients, botulinum toxin (or Botox) has effectively been shown to be an alternative medication. CASE REPORT: Following Botox administration for chronic headaches, our patient developed unforeseen adverse effects and presented with severe neck stiffness, facial droop, and dysphagia, collectively known as dropped head syndrome, prompting them to seek emergency care. In order to counteract botulinum toxicity, we administered neostigmine, but unexpectedly induced cholinergic toxicity, which led to severe secretions and blurry vision. Glycopyrrolate was administered with responsive resolution of symptoms. CONCLUSIONS: This case highlights the complexities of managing adverse reactions to Botox and raises considerations for alternative treatments, such as atropine, or concurrent neostigmine treatment with glycopyrrolate. KEY WORDS: Botox, botulinum, dropped head syndrome, chronic migraine, migraine, multiple sclerosis
Comprehensive Review for the Treatment of Multilevel Thoracic Compression Pain with a Case Report Demonstrating Use of Peripheral Stimulation
Authors: Ampomah Kwasi
Published: October 2024

BACKGROUND: The pain, compromised spinal biomechanics, and limited mobility caused by thoracic vertebral compression fractures present complex clinical challenges. Conventional treatments for this condition have limitations, necessitating innovative solutions. Peripheral nerve stimulation (PNS), which interrupts pain-signaling pathways, offers a minimally invasive approach. CASE REPORT: We report a 20-year-old woman with T9 and T7 thoracic compression fractures resulting from a horse-riding accident. Although she had received the standard interventions, her pain persisted. PNS was introduced, resulting in an 85% pain reduction and improved quality of life for the patient. PNS utilizes neuromodulation principles to target peripheral nerves, intercepting nociceptive signals. CONCLUSIONS: This case highlights PNS’s potential as a transformative therapeutic strategy for thoracic compression fractures. PNS offers personalized pain relief with minimal invasiveness, making it a promising alternative to conventional treatments. As the prevalence of osteoporosis rises, PNS holds promise for better outcomes and enhanced quality of life in patients with vertebral compression fractures. KEY WORDS: Peripheral nerve stimulation (PNS), thoracic compression fracture, vertebral integrity, neuromodulation, pain management, case report
Predictors of a Favorable Response to Transforaminal Epidural Steroid Injections for Lumbar Radiculopathy in the Elderly
Authors: Song Li
Published: October 2024

BACKGROUND: The efficacy and its associated predictors of transforaminal epidural steroid injection (TFESI) in elderly patients with lumbar radiculopathy are unknown. OBJECTIVE: The purpose of this retrospective study was to identify the efficacy of TFESI in elderly patients with lumbar radiculopathy and its associated predictors of long-term outcomes. STUDY DESIGN: Retrospective study. SETTING: Interventional pain clinics in West China Hospital of Sichuan University. METHODS: In total, 294 elderly patients who were diagnosed with lumbar radiculopathy and underwent transforaminal epidural steroid injections from January 2019 through January 2022 were retrospectively analyzed. Demographic, clinical, magnetic resonance imaging, and TFESI-related information was collected to assess the predictive factors of long-term outcomes of the TFESI. Pain scores were assessed using the Numeric Rating Scale. Treatment success was defined as a >= 50% reduction in pain scores at 6 months. RESULTS: Multivariate logistic regression analysis revealed that the duration of symptoms, immediate postoperative response, and neutrophilic granulocyte percentage were independently associated with a favorable response to TFESI. In addition, the level of pain at the initial visit and the number of TFESI performed were also associated with a good response in the multivariate regression analysis, even though the association was not statistically significant. LIMITATIONS: Approximately 6% of the patients were lost to follow-up; therefore, selection bias may have slightly influenced our findings. In addition, our patients were not compared with a control population, and consequently, a placebo effect could not be assessed. CONCLUSION: This study revealed that a short duration of symptoms, good immediate postoperative response and high neutrophilic granulocyte percentage were long-term predictors of a good response to TFESI in elderly patients with lumbar radiculopathy. KEY WORDS: Elderly, radiculopathy, epidural injection, predictors, neutrophil
Intrathecal Analgesia via a Percutaneous Port With Patient-Controlled Intrathecal Analgesia for the Management of Movement-Evoked Breakthrough Cancer Pain of Refractory Lower Extremity Cancer Pain: A Retrospective Review
Authors: Zhou Liang , Guo Zhenggang
Published: October 2024

BACKGROUND: Intrathecal analgesia (ITA) is a valuable treatment option for refractory cancer-related pain. However, there is still no general consensus on the analgesic effect of movement-evoked breakthrough pain (MEBTP) in the ITA setting. OBJECTIVES: This study aimed to conduct a retrospective observational study to examine the effect of ITA via percutaneous port (ITAPP) with patient-controlled ITA (PCIA) on analgesic efficacy, emphasizing MEBTP in patients with refractory lower extremity cancer pain. STUDY DESIGN: A retrospective chart review included all patients with refractory lower extremity cancer pain who received ITAPP at our hospital between January 2017 and December 2020. METHODS: Data on the Numeric Rating Scale scores of spontaneous resting pain intensity (SRPI) and MEBTP intensity (MEPI), opioid doses, and perceived time to onset were collected from medical records prior to ITAPP and at a one-month postimplant visit. RESULTS: A total of 16 patients were included in the study group. Mean SRPI decreased from 8.75 pre-ITAPP to 3.75 post-ITAPP (P < 0.05); mean MEPI fell from 8.83 pre-ITAPP to 4.25 post-ITAPP (P < 0.05); mean daily morphine equivalent dosing decreased from 360 mg/d to 48 mg/d (P < 0.05); and mean daily morphine equivalent dosing for MEBTP decreased from 87 mg/d to 6 mg/d (P < 0.05). Both total and breakthrough dosing of conventional opioid medications significantly decreased following the initiation of ITAPP with PCIA. The mean perceived time to onset with conventional MEBT medications was 38 minutes, and the mean perceived time to onset with PCIA was 8 minutes (P < 0.05). LIMITATIONS: An effective analysis of IT opioid efficacy was not possible because the power of such a small sample size was low. Second, it is a retrospective study without long-term follow-ups. CONCLUSIONS: In patients with refractory lower extremity cancer pain, ITAPP with PCIA was associated with improved pain control. Compared with conventional MEBTP regimens, appropriate ITAPP with PCIA provided superior analgesia and a much faster onset of action. KEY WORDS: Movement-evoked breakthrough pain, patient-controlled intrathecal analgesia, lower extremity cancer pain, intrathecal analgesia via a percutaneous port
Associations Between Headache (Migraine and Tension-Type Headache) and Psychological Symptoms (Depression and Anxiety) in Pediatrics: A Systematic Review and Meta-analysis
Authors: Chang Min Cheol
Published: October 2024

BACKGROUND: There have been no recent meta-analysis studies on specific psychological symptoms (depression and anxiety) according to the type of primary headache disorder in children and adolescents. OBJECTIVES: We performed a meta-analysis of various psychodiagnostic scales. Psychological symptoms of primary headache disorders have been reported in previous studies. STUDY DESIGN: A systematic review and meta-analysis. METHODS: We conducted systematic reviews using the PubMed, Embase, Cochrane Library, and Scopus databases up to October 19, 2022. Ten studies were selected by applying the inclusion criteria. The psychological symptoms (depression and anxiety) of children and adolescents with migraine and tension-type headache (TTH) were compared with those of healthy controls using scale scores. All statistical analyses of the pooled data were performed using RevMan 5.3 software. RESULTS: Psychodiagnostic tools to assess depression scored higher in patients with migraine than in healthy controls; however, most anxiety-related scores were not significantly different between the migraine and control groups. In contrast, anxiety-related scores were higher in patients with TTH than in healthy controls, but the score to measure the degree of depressive symptoms was not significantly different from the control group in patients with TTH. LIMITATIONS: A limited number of studies for each scale were included. In addition, each scale has different sensitivities and specificities, which may have affected the results. In addition, we did not evaluate the differences in psychological symptoms according to the frequency and severity of headaches. CONCLUSIONS: Depression is more associated with migraine; whereas, anxiety is more associated with TTH than healthy controls. Therefore, the screening and assessment of psychological symptoms should be performed in children and adolescents with primary headache disorders. KEY WORDS: Headache, migraine, tension-type headache, depression, anxiety, children, adolescents
Co-treatment with Oral Duloxetine and Intraarticular Injection of Corticosteroid plus Hyaluronic Acid Reduces Pain in the Treatment of Knee Osteoarthritis
Authors: Luo Fang
Published: October 2024

BACKGROUND: Knee osteoarthritis (OA) is a common form of arthritis in elders which can lead to reduced daily activity and quality of life. It is important to administer a proper treatment with high efficacy and low side effects. In this study, we evaluated the efficacy of co-treatment with oral duloxetine and intraarticular (IA) injection of hyaluronic acid (HA) and corticosteroid (CS) in patients with knee OA. OBJECTIVES: This study aimed to test the hypothesis that an IA injection of CS+HA combined with duloxetine could achieve pain management superior to that of an IA injection of CS+HA alone in patients experiencing knee OA related pain. STUDY DESIGN: This study adopted a prospective, randomized, open-label blind endpoint study design. SETTING: The investigation was performed at Beijing Tiantan Hospital Affiliated with the Capital Medical University from October 2019 to December 2021. The study plan was approved by the Ethics Committee of Beijing Tiantan Hospital (KY 2019-086-02). METHODS: A total of 150 patients were randomly allocated to receive either duloxetine combined with an IA injection (n = 75) or a single IA injection alone (n = 75). All patients were followed for 24 weeks. The primary outcome was the change in the weekly 24 hours average mean pain scores, and the secondary outcomes included the proportion of patients with >= 30% or >= 50% pain reduction, Brief Pain Inventory (BPI) items, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, Patient Global Impression Improvement (PGI-I) ratings, hospital anxiety and depression scale (HADS) scores and adverse events (AEs). RESULTS: Patients in the experimental group had significantly greater improvement in the change of weekly mean of the 24 hours average pain scores, BPI pain severity ratings (P < 0.001) and WOMAC scores (P < 0.001) at the study endpoint. A significantly greater percentage of patients in the experimental group rated PGI-I of <= 2 (P = 0.021) and >= 50% pain reduction (P = 0.029) at 24 weeks. There was no difference in the proportion of patients with <= 30% pain reduction, the HADS scores or frequency of AEs between the 2 groups. LIMITATIONS: The effectiveness and safety were examined only up to 24 weeks after treatment, and we did not perform a long-term follow-up as most previous studies have. Optimum dosage of duloxetine, as well as different molecular-weight HA, should be investigated in future studies. CONCLUSION: Patients receiving co-treatment with oral duloxetine and IA (HA+CS) injections experienced considerable improvement in pain and knee function compared to those who received an IA injection alone. KEY WORDS: Pain management, co-treatment, duloxetine, intraarticular injection, knee osteoarthritis, hyaluronic acid, corticosteroid
Motor Control Exercise Modulates the Neural Plasticity of the Default Mode Network in Patients with Chronic Low Back Pain
Authors: Wang Chuhuai
Published: October 2024

BACKGROUND: Motor control exercise (MCE) effectively alleviates nonspecific chronic low back pain (CLBP), but the neural mechanisms underlying this phenomenon are poorly understood. OBJECTIVE: To study MCE’s neural mechanisms in patients with CLBP by resting-state functional magnetic resonance imaging (rs-fMRI). STUDY DESIGN: A prospective, single-blind, randomized, controlled trial. SETTING: Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University. METHODS: 58 patients were randomly assigned to either the MCE or the Manual Therapy (MT) group. Before and after treatment, all the patients underwent ultrasound imaging to measure transversus abdominis (TrA) activation, rs-fMRI scans and questionnaire assessments. We analyzed the activation and connectivity of the bilateral precuneus based on the fractional amplitude of low-frequency fluctuation (fALFF) and effective connectivity (EC) analyses. Further, we determined the association between imaging and clinical measures. RESULTS: Pain intensity, pain catastrophizing, and pain-related disability were alleviated significantly in both groups post-treatment. However, the MCE group showed a greater reduction in pain-related disability and a better improvement in activation of the right TrA than the MT group. After MCE, patients showed an increase in regional fALFF values in the key node of the default mode network (bilateral precuneus) and decreased EC from the bilateral precuneus to the key node of the frontoparietal network (the left dorsolateral prefrontal cortex (DLPFC)). The pre-to-post-treatment change in the EC from bilateral precuneus into the left DLPFC was significantly correlated with the pre-to-post-treatment change in visual analog scale scores and activation of the right TrA in the MCE group (r = 0.765, P < 0.001 and r = 0.481 and P = 0.043 respectively). LIMITATIONS: The present study showes the correlation between the alteration of brain functions and CLBP-related symptoms, which does not reveal the causal effect between them. Further, this study does not estimate the long-term efficacy of MCE on brain function, and the sample size was not calculated based on fMRI data. CONCLUSION: These findings demonstrate that MCE may alleviate CLBP symptoms in patients by modifying information transmission from the default mode network to the left frontoparietal network. KEY WORDS: Chronic low back pain, motor control exercise, resting-state functional magnetic resonance imaging, granger causality analysis, precuneus, default mode network, dorsolateral prefrontal cortex, frontoparietal network
PROGRAM PENINGKATAN PENGETAHUAN DAN KEAHLIAN GURU DAN SISWA SEKOLAH MENENGAH PERTAMA TERHADAP SEARCH ENGINE OPTIMIZATION
Authors: Herman  , Riadi Imam , Chandra Kurniawan Gusti , Adhi Prabowo Basit
Published: October 2024

Mahasiswa Magister Informatika Universitas Ahmad Dahlan melakukan Program Pemberdayaan Umat (PRODAMAT) dengan tema Search Engine Optimization (SEO) di Sekolah Menengah Pertama (SMP) Muhammadiyah 1 Berbah Sleman. Salah satu problem di dalam melakukan dakwah melalui dunia maya adalah konten tidak muncul di halaman pertama mesin pencari meskipun konten dibuat lebih dulu. PRODAMAT ini bertujuan untuk meningkatkan keahlian menulis judul dan konten menerapkan SEO sehingga memperbesar peluang konten muncul di halaman pertama mesin pencari. Pelatihan ini diikuti 17 guru, 10 siswa dan satu karyawan SMP Muhammadiyah 1 Berbah Sleman secara luring di laboratorium komputer sekolah. Pretest dilakukan sebelum melakukan pelatihan. Sesi pertama memberikan materi tentang faktor-faktor yang mempengaruhi indexing mesin pencari agar konten muncul di halaman pertama yang ditampilkan oleh mesin pencari berdasarkan kata kunci. Sesi pertama juga memberikan materi tentang cara menulis konten dengan template yang menerapkan SEO. Sesi kedua mempraktikkan pembuatan template yang menerapkan SEO dan menulis konten menggunakan template yang sudah dibuat. Posttest dilakukan setelah pelatihan usai. Hasil tes pretest dan post test menunjukkan bahwa nilai persentase guru meningkat 26%, persentase siswa meningkat 31% dan persentase karyawan meningkat 45%. Secara keseluruhan, nilai persentase meningkat 28%. Hasil ini mengindikasikan adanya peningkatan yang signifikan dalam pengetahuan wawasan dan soft skill tentang penerapan SEO tanpa menggunakan tools SEO.Kata Kunci: SEO, Template, Konten