bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Motoric Outcome after Early Craniectomy in Patient with Open Depressed Fracture Involving Motoric Cortex Area : A Case Report
Authors: Husain Syekh Ahmad Arafat , Hutagalung Tommy Rizky , Lizen Nindi , Mahyudanil  
Published: September 2022

Introduction : Traumatic brain injury (TBI) remains a major public health problem worldwide. It is a leading cause of mortality and disability across the globe. Brain swelling and intracranial hypertension are well-recognized secondary insults associated with increased mortality and poorer outcomes. In majority of head injury cases, the incidence of depressed skull fracture is also increasing. When this situation involving in motoric cortex area, it can cause limb weakness and devastating effect.
Case Report : We reported a 21 year old male patient came with complaints of decreased consciousness due to a motorcycle accident. On motoric examination, hemiplegia was found in the left limb. There was a open wound in the right fronto-parietal region, Head CT Scan revealed a depressed fracture in the right fronto-parietal region and multiple contusions on the right frontal. Craniectomy procedures was performed. Post operatively there is an improvement in patient consciousness and motoric outcome.
Discussion : Open depressed fracture is one of the most common traumatic brain injury (TBI). Prevent infection and saving traumatic penumbra is the main target of surgery in this case. The pathophysiological changes in the traumatic penumbra are dynamic processes, the development and outcome of TBI depends greatly on the progression of tissue damage in the traumatic penumbras. Early clinical treatment can effectively rescue the tissue which has the potential to recover and hinder the progression of secondary injury
Conclusion : Traumatic brain injury (TBI) has high morbidity and mortality in worldwide. Time dependent progression has provided a window of opportunity to take interventional action and reduce secondary injury after TBI. Motoric outcome can improve with early management.
Microsurgical Resection of Cerebral Arteriovenous Malformation: Our Precious Experience
Authors: Irsyad Muhammad Ari , Hutagalung Tommy Rizky , Putra Prawira Buntara , Tala Muhammad Ihsan Zulkarnain 
Published: September 2022

Introduction : Intracranial ateriovenous malformation (AVM) is a non-neoplastic congenital vascular abnormality which appears as a mass lesion composed of tangled blood vessels connecting arteries and veins in the brain.
Case Report : Twenty seven years old male was present in our emergency department (ED) with decreased of conciousness and reccurent generalized seizure. The physical examination reveal the patient Glasgow coma scale (GCS) of 12 points (E4M5V3). Head CT scan with contrast shows contrast enhancing lesion on the frontoparietal region with extension to right lateral ventricle which suggest vascular lesion. We performed surgical resection of the AVM using the temporary clip on M2 branch which supply the nidus to reduce the risk of bleeding on operation.
Discussion : Patients with grade I or II AVM tolerate resection with acceptable morbidity, whereas those with a grade IV or V AVM may be considered for conservative management because of the high anticipated risk of surgical morbidity
Conclusion : AVMs are abnormalities of the intracranial vessels that constitute a connection between the arterial and venous systems and lack an intervening capillary bed. Microsurgical excision of the AVM involves a craniotomy, careful dural opening with circumferential nidus dissection until complete AVM resection is achieved.
Overview of Patients with Metastatic Brain Tumors from Breast Cancer at H. Adam Malik Hospital, Medan in 2017-2021
Authors: Rasyid Fahmi , Alloyna Dhyka , Basri Kamal 
Published: September 2022

Abstract
Introduction: The incidence of breast cancer based on Globocan in 2018, reached 2,088,849 cases (11.6%), with a mortality rate of 626,679 cases (6.6%). Breast cancer is one of the most common causes of a metastatic brain tumor. Approximately 10%-16% of patients with breast cancer develop brain metastases during the course of their disease. Current case management guidelines for patients with metastatic brain tumors from breast cancer are radiotherapy to the entire brain, with or without surgical resection, or stereotactic radiosurgery. Hormone receptor ([HR]; estrogen receptor [ER], progesterone receptor [PR]) and HER2 expression serve as predictors of response to hormone-targeted therapy and HER2, respectively.
Method: The study was a descriptive study with a retrospective cohort design in which the researchers identified 78 patients with breast cancer brain metastases (either for diagnostic purposes or for therapeutic purposes at RSUP HAM Medan between 2017 and 2021. Data were collected from SIRS RSUP HAM Medan. Data related to clinicopathology were collected from medical records, including demographic characteristics, tumor characteristics, biomarker status, recurrence of metastatic brain tumors based on Magnetic Resonance Imaging (MRI) examination, and data on therapeutic regimens in cases of brain metastases of breast cancer. ER and PR status were determined by immunohistochemical examination. the intensity of the HER2 3+ immunohistochemical staining was considered positive
Result: The mean age at breast cancer diagnosis was 46 years (range: 24-73 years). Most patients had invasive ductal histology (n=73, 94%). In addition, 56% of patients had T3 (n=34) T4 disease in 56% of patients (n=44) and 68% of patients (n=53) had positive axillary lymph nodes. Among patients with known HR and HER2 status, a total of 56% of tumors were ER negative (ER-; n=44), 62% were PR negative (n=48), and 44% were HER2-positive (HER2+; n= 34). With regard to the four subtypes formed by the combined values of HR and HER2 status, 21% (n=16) of tumors were HR+HER2+, 27% (n=21) were HR+HER2-, 23% (n=18) were HR+/ HER2-, and 28% (n=23) were triple negative (TN).
Discussion: In the current study, investigators found that apart from patient age and number of brain metastases, HER2 status was a strong predictor of survival outcome after brain metastases. Patients with HER2-positive characteristics had a longer life expectancy than patients with HER2-negative disease. Considering the intracranial antitumor effect of anti-HER2 therapy, it is important to establish HER2 status not only in primary tumors but also in brain metastases to aid in consideration of the choice of therapeutic modality
Conclusion: This study showed that younger age, brain metastases from solitary breast cancer, and HER2 positive from breast tumors were independent predictors of better survival in patients with breast cancer brain metastases
Intradural Extramedullary Spinal En-Plaque Meningioma With Calcification: A Case Report And Literature Review
Authors: Siregar Rais , Ibrahim Sabri 
Published: September 2022

Abstract
Introduction: Intradural extramedullary (IDEM) tumors are benign neoplasms arising in the spinal canal about two-thirds of primary spinal tumors and 15% of tumors affecting the Central Nervous System. Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like, and incidence in the literature only ranging from 0.1% to 3.1%. Pain is the most clinical symptom, weakness and sensory changes also occur frequently. Magnetic resonance imaging (MRI) is the standard modality for the radiologic diagnosis of meningioma.
Case Report: A patient, 35 years old man with a diagnosis of intradural extramedullary spinal meningioma (IDEM) en-plaque with calcification, confirmed by the symptoms, workups such as spinal MRI, and intra-operative findings. The patient was successfully treated surgically with laminectomy and total tumor resection with a posterior approach.
Discussion: Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like manner around the spinal cord can involve dura extensively with significant neurological deficits. Patient was with lower limb weakness, and had a history of back pain radiating to the right limb for the last 1 year. Spinal meningiomas are primarily found in the Intradural Extramedullary, and the tumor diagnosis is typically fairly straight forward based on radiologic findings. Meningiomas are most commonly found in the thoracic region of the spine. In this case from MRI Imaging was revealed a mass in thoracic region of the spine pressing the spinal cord anteriorly. The management of spinal en-plaque meningioma is tumor resection surgery. A retrospective study suggested a significant improvement in neurological deficit post-tumor resection on patients with spinal IDEM tumor.
Conclusion: Spinal meningioma is a reasonably frequently found case of a spinal tumor but spinal en-plaque meningiomas are rarely found. MRI scan is the radiological gold standar diagnose spinal en-plaque meningiomas. Patient was successfully treated by total tumor resection using the laminectomy method and tumor resection with a posterior approach without any postoperative complications observed.
The Neuromodulator Effect of Vagal Nerve Stimulation as the Treatment of Medically Refractory Epilepsy in Comparison with Surgical Approach: A Systematic Review
Authors: Anas Muhammad Al , Ritonga Dwi Herawati 
Published: September 2022

Background: Restorative options in medically refractory epilepsy are restricted to ablative brain surgery, the trial of antiepileptic medications, or palliative procedures. Vagal nerve stimulation (VNS) is an accessible palliative method of which the mechanism of action isn't well understood, yet with set up adequacy for medically refractory epilepsy and low occurrence of incidental effects.
Objectives: This systematic review aimed to evaluate the action of epilepsy treatment options.
Methods: We searched for relevant studies published in 2016-2021 with PRISMA charts. For English published statistical analyses, we include all studies conducted on pediatric epileptic patients who have undergone epilepsy surgery and VNS.
Results: Antiepileptic impacts of VNS incorporate expanded movement of the locus coeruleus (LC) neurons with a raised norepinephrine (NE) discharge in the hippocampus, cortex, and amygdala. VNS-modulatory consequences for other synapse frameworks such as cholinergic, GABAergic, and glutamatergic depend on the activation of the LC-NE pathway. While in pediatric epilepsy, early surgical intervention is frequently recommended to work on cognitive and behavioral outcomes that unequivocally portray the epileptogenic zone.
Conclusion: The general rate of complication caused by epilepsy surgery was sensibly low (5%), suggesting that epilepsy medical procedures, particularly primarily temporal lobe resection, can be safe preferably with recent procedure options, while VNS could be more effective as therapy begins at early stages pre- or post-seizure onset to decide the preventative role of VNS in human epileptogenesis when the treatment is given promptly.
Late Presentation of Testicular Torsion : A Case Report
Authors: Kalangi Ottofianus Alvedo Hewick , Ardiyansyah Muhammad Fadhil , Andre Laurentius 
Published: September 2022

Introduction: Testicular torsion is a twisting of the spermatic cord, which results in impaired blood flow to the testicle. This urological emergency occurs 3.8 per 100,000 males annually, most often observed younger than 18 years. The left testis is more frequently involved. Bilateral cases report for 2% of all torsions. We describe a male with a late presentation of more than 24 hours of acute testicular pain. Patients hesitate to seek advice from doctors for testicular pain because of unawareness.
Case Reports: A 16-year-old man arrived at the Emergency Room with more than 24 hours history of sudden severe left testicular pain after taking up two gas cylinders, but he was not aware. After more than 24 hours, he came to the emergency room with worsening testicular pain. The physical examination found tender, slightly swollen, and high-riding left testes. Phren test and cremaster reflex were negative on the left testes. TWIST score of the patient was 7 (high risk for testicular torsion). We made quick order for ultrasound, which shows left testicular torsion. Emergency exploration of testes was done, found the necrotic left testes with rotation more than three times. After complete derotation of the cord, the testes were still necrotic, and we decided to do left side orchidectomy after enough observation.
Conclusion: Late presentation to the hospital is one of the causes of delay in treatment and mostly leads to orchidectomy in testicular torsion. Every case of testicular pain should be treated as testicular torsion until proven otherwise.
Keyword: Emergency, Late presentation, Orchidectomy, Testicular torsion.
Surgical Procedure And Future Treatment Options For Posttraumatic Syringomyelia : A Systematic Review
Authors: Ananda Sigit , Iskandar  , Hamzah Zaini 
Published: September 2022

Objectives
To find the most effective surgical procedure for posttraumatic syringomyelia (PTS) in the last 1 decade. And to look for the latest therapeutic strategies that have the opportunity to be developed in the future.
Background
Syringomyelia related trauma is uncommon case compared to other etiology such as Chiari Malformation type 1. The management of PTS is remain unclear and debatable. The aim of this study is to review PTS regarding surgical procedure, outcomes, and potential future treatment strategies.
Methods
This study uses a structured analyses focused on preferred reporting items for systematic review and meta-analyzes (PRISMA). Document selection using the keywords “Postraumatic Syringomyelia” AND “Syringomyelia” and based on publication (10 years). We selected based on the 2020 PRISMA checklist and based on inclusion and exclusion criteria. A total 17 studies met the eligibility criteria. We recorded treatment strategies, level of syrinx, severity of injury, injury to symptom duration and outcomes.
Results
A total 264 participants with PTS from 15 observational studies and 2 clinical trials were reviewed. We recorded 68% of participants were treated surgically (n=181). The most common procedure is arachnoid lysis and duraplasty (32,5%, n= 59) followed by syrinx shunting (15,4%, n=28) and subarachnoid-subarachnoid bypass (11%, n=20). We found that the syrinx shunting was the most successful procedure with symptoms improved in 82% of patients postoperatively. Overall, symptoms improved in 60% participants who underwent surgery (n=110). We also found deterioration from surgical procedure in 18% participants (n=32). Beside of surgical strategy we also found another therapeutic option that use mesenchymal stromal cells (MSCs) that injected into the syrinx. We recorded a 100% success rate from this procedure (n=7)
Conclusion
Although the overall outcomes of the surgical procedure for PTS are still unsatisfactory, the syrinx shunting procedure seems to be considered as the most effective surgical procedure. Other therapeutic strategies such as MSCs is considered promising but still require further researches with larger sample sizes.
Keywords : syringomyelia, syrinx shunting, trauma
Liver cirrhosis with its complications: Case report in a young female patient
Authors: Muhammad Hanun Mahyuddin  , Ulaa Haniifah  
Published: September 2022

Liver cirrhosis is a chronic disease characterized by the presence of fibrosis and regeneration of nodules in the liver, the consequence of which is the development of portal hypertension and liver failure. Usually associated with infectious infectious diseases such as viral hepatitis, alcohol consumption, metabolic syndrome, autoimmune processes, storage diseases, toxic substances and drugs. Major complications include gastrointestinal variceal bleeding, ascites, spontaneous bacterial peritonitis infection, hepatorenal syndrome, hepatic encephalopathy, and hepatocellular carcinoma.
A 23-year-old woman comes to the ER, dr. Soegiri Lamongan with complaints of vomiting blood. The patient also complained of black bloody stools. Referred patient from Intan Medika Hospital with the initial complaint of vomiting blood more than 5 times (± equivalent to one medium drinking bottle) four days ago. On examination also found anemic conjunctiva and found splenomegaly. On abdominal ultrasound examination, the liver was shrunken, the edges were obtuse angles, partially irregular, parenchymal echo intensity was heterogeneous, v.hepatica was normal, liver fibrosis staging was 11.81 kPa, no masses or nodules were seen. The conclusion on endoscopic examination was the presence of grade III esophageal varices, congestive gastropathy, and erosive gastritis.
Liver cirrhosis is a disease that has various etiologies. Early diagnosis and appropriate treatment in cirrhotic patients with complications is one way to improve patient survival
PERANAN ANGGARAN DALAM MENINGKATKAN PENGAWASAN BIAYA OPERASI PADA PT. HARUN NAULI MEDAN
Authors: NASUTION MHD HAFIZ AKBAR 
Published: September 2022

Penelitian ini dilandaskan pada pemikiran bahwa peranan anggaran sebagai alat pengawasan sangatlah penting karena suatu perencanaan yang tidak diikuti oleh pengawasan merupakan pekerjaan yang sia-sia. Bagaimanapun baiknya suatu perencanaan tidak akan mencapai tujuan tanpa pengawasan yang baik. Perusahaan yang diangkat dalam penelitian ini yaitu PT. Harun Nauli Medan yang bergerak dibidang jasa kontruksi yakni pembangunan perumahan , jembatan dan jalan. Setiap periode akuntansi perusahaan ini senantiasa menyusun dan melaksanakan anggaran biaya. Dimana perusahaan menggunakan anggaran dalam meningkatkan pengawasan biaya operasionalnya. Adapun anggaran yang disusun oleh pihak manajemen perusahaan dimaksudkan agar kegiatan operasional yang direncanakan dapat berjalan dengan lancar dan juga agar tugas masing-masing bagian yang terkait didalamnya dapat dilaksanakan dengan baik. Dari data-data mengenai anggaran dan realisasinya sejak tahun 2018 s/d 2021 diketahui bahwa terdapat selisih antara anggaran dan realisasinya. Selisih ini merupakan selisih menguntungkan ( favorable) karena anggaran lebih besar dari pada realiusasinya. Perumusan masalah dalam penelitian ini adalah apakah anggaran sudah berperan sebagai alat sebagai alat pengendalian biaya operasional? Sedang tujuan penelitian ini adalah bagai mana penyusunan , pelaksanaan anggaran, peran anggaran tersebut dalam pengawasan biaya operasi. Hasil penelitian yang diperoleh dan sekaligus menjadi kesimpulan dari mpenelitian ini antara lain bahwa dalam pelaksanaan kegiatan operasional perusahaan anggaran yang dibuat, terdapat sedikit perbedaan dengan realisasinya., namun penyimpangan yang terjadi tidak begitu besar dan tidak cukup berarti. Akan tetapi pada proses perencanaan penyusunan anggaran PT. Harun Nauli Medan masih belum melakukan pengklasifikasian biaya, misalnya mana yang termasuk biaya tetap, biaya variabel, dan biaya semi variabel. Semua biaya-biaya dijadikan satu kelompok kedalam biaya pemasaran dan biaya administrasi dan umum. Untuk itu, alangkah baiknya jika dalm menyusun anggaran perusahaan pengelompokan biaya dilakukan dengan lebih spesifik dan jelas,dan anggaran terrsebut harus bersifat fleksibel agar anggaran yang disusun tersebut dapat lebih efektif dan efisien guna mempertahankan kemampuan dalam memperoleh laba bersih perusahaan.
ANALISIS HUKUM TERHADAP PENYELESAIAN SENGKETA HARTA BERSAMA MENURUT KOMPILASI HUKUM ISLAM
Authors: Yusriana Yusriana 
Published: September 2022

Keluarga yang baik, bahagia lahir bathin adalah dambaan setiap insan. Namun demikian tidaklah mudah untuk mewujudkan sebuah keluarga bahagia, langgeng, aman, dan tentram sepanjang hayatnya. Perkawinan yang sedemikian itu tidaklah mungkin terwujud apabila diantara para pihak yang mendukung terlaksananya perkawinan tidak saling menjaga dan berusaha bersama-sama dalam pembinaan rumah tangga yang kekal dan abadi.
Apabila terjadi perceraian sudah dapat dipastikan akan menimbulkan akibat-akibat terhadap orang-orang yang berkaitan dalam suatu rumah tangga, dimana dalam hal ini akibat hukumnyalah yang akan dititik beratkan. Akibat hukum dari perceraian ini tentunya menyangkut pula terhadap anak dan harta kekayaan selama dalam perkawinan.
Dalam menetapkan putusan sengketa harta bersama antara suami dan isteri Kompilasi Hukum Islam merupakan standard hukum yang dipergunakan pada pengadilan agama, sebagaimana dijelaskan dalam pasal 88 Kompilasi Hukum Islam.
Kompilasi Hukum Islam pasal 85 sampai dengan pasal 97 merupakan hukum terapan dan sinkron dalam penyelesaian sengketa harta bersama antara suami dan isteri untuk saat ini.
ETIKA BERBAHASA DALAM TRANSAKSI JUAL BELI
Authors: Rostina Rostina 
Published: September 2022

Bahasa digunakan sebagai alat untuk berkomunikasi dan berfungsi untuk menjalin hubungan, memelihara, serta menjalin keakraban antara penuturnya. Bahasa yang ada di pasar sangat beragam dalam penggunaannya, hal tersebut dikarenakan penutur yang heterogen dan memiliki latar belakang sosial dan kebiasaan yang berbeda. Keberadaan masyarakat yang memiliki bahasa yang beragam membuat bangsa ini kaya akan keragaman bahasa yang digunakan. Keragaman bahasa biasanya dipengaruhi oleh penggunaan dari penutur dan mitra tutur. Pemakaian suatu bahasa terjadi dalam masyarakat tutur. Menurut Fishman (dalam Chaer dan Leoni, 2010:36), masyarakat tutur merupakan masyarakat yang setidaknya mengenal satu variasi bahasa dan norma yang sesuai penggunaannya. Bahasa dan penggunaannya di dalam masyarakat tidak diamati secara individu, tetapi dihubungkan dengan suatu kegiatan yang ada di dalam masyarakat tersebut. Oleh karena itu, masyarakat dan bahasa merupakan satu kesatuan yang berhubungan erat dan saling membutuhkan satu sama lain. Tanpa bahasa, komunikasi antara seorang individu dengan individu lainnya tidak akan berlangsung dengan baik.
PERLINDUNGAN HUKUM BAGI DEBITUR JAMINAN HAK TANGGUNGANNYA TELAH DILELANG TANPA MELALUI RESTRUKTURISASI KREDIT
Authors: Tarmizi Tarmizi 
Published: September 2022

Restrukturisasi tidak wajib dilakukan didalam kredit bermasalah di perbankan akan tetapi dapat dilakukan, karena tidak wajib maka dapat dilaksanakan lelang, bank dapat melakukan resturkturisasi, jika ada kesepakatan di dalam perjanjian kredit antara bank dan debitur maka harus melalui restrukturisasi, dan jika tidak ada kesepakatan maka bank dapat langsung melakukan lelang terhadap objek jaminan. Apabila restrukturisasi gagal, yaitu debitur tidak mampu memenuhi kewajibannya, maka dapat melakukan perjanjian ulang antara debitur dan bank dengan menyesuaikan kemampuan usaha debitur. Oleh karena itu, bilamana objek jaminan dilelang tanpa melalui restrukturisasi kredit maka akibat dari adanya konflik norma Pasal 6 Undang-Undang Hak Tanggungan Pasal 224 HIR, yaitu timbulnya ketidakpastian hukum mengenai pengaturan pelaksanaan Eksekusi Barang Jaminan yang telah dibebani Hak Tanggungan, dengan adanya gugatan telah mengakibatkan peserta lelang mengundurkan diri dari pelaksanaan lelang Hak tanggungan.