BACKGROUND: The World Health Organization declared the novel coronavirus disease 2019 (COVID-19) a global pandemic, which classifies the outbreak as an international emergency. This disease has been confirmed as the first pandemic in 21st century. Healthcare workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of being stigmatized. AIM: This study was a review. METHODS: This study was conducted by conducting analytic appraisal using published journals and sources through an electronic database. RESULTS: From cases in Indonesia and other countries, there’s bunch of examples that healthcare workers being negatively stigmatized in case of COVID-19. They lost their rights to have a normal life in this pandemic era. DISCUSSION: The government itself has actually promoted socialization about COVID-19, including the importance of mutual support and assistance including morally and psychosocially for the sufferers and health workers involved. However, negative stigma for health workers and patients and their families suffering from COVID-19 remains strongly attached until nowadays. Synergy between the central government, regional governments, community leaders, and referral hospital officials are certainly important to overcome this stigma problem, in addition to promoting education in the community. CONCLUSION: Synergy among the central government, regional governments, community leaders, and referral hospital officials is certainly important to overcome this stigma problem, in addition to promoting education in the communit

Traumatic brain injury (TBI) following increased intracranial pressure (ICP) is a neuroemergency case which should be managed promptly to prevent secondary brain injury. This will lead to a condition called cerebral energy dysfunction which is an important determinant factor toward worse outcome. Lactate, which was historically known as an end waste product, now is considered as an alternative cerebral energetic fuel. Hypertonic sodium lactate (HSL) is a promising hyperosmolar fluid which serves not only to decrease ICP but also to readily supply exogenous lactate to fulfill increased cerebral energy demand. Pioneer studies have shown the harmlessness and usefulness of HSL in treating pathological condition including TBI.

BACKGROUND: Cranioplasty is aimed to restore the structure and function of the lost portion of the skull defect. Many materials can be used for cranioplasty, such as the bones of the patient (autograft), the bones of other patients (allograft), bones of animals (xenograft), or synthetic materials such as acrylic or titanium mesh. These materials are quite expensive and sometimes require complex processes. Manual shaping of material for cranioplasty is also quite time-consuming and prone to cause esthetic dissatisfaction. The author will discuss the case of using polylactic acid (PLA) implant with 3-dimensional (3D) printing customization as a cheap and accurate cosmetic solution for cranioplasty procedures. CASE REPORT: We report 2 cases of skull defect underwent cranioplasty. The first case, female, 20-year-old, had a history of severe traumatic brain injury (TBI) and epidural hematoma. She underwent decompression craniotomy on the left frontotemporoparietal region of her skull. The second case, male, 46-year-old, had a history of spontaneous intracerebral hemorrhage due to arteriovenous malformation (AVM). He underwent decompression craniotomy on the right frontotemporoparietal region of her skull. Both the data of computerized tomography (CT) scan were reconstructed to get 3D model of skull defect. Prosthesis was made by 3D printer accordingly using PLA as material. There was no complication reported postoperatively and cosmetic satisfaction was obtained on both cases. CONCLUSION: The use of PLA implant with 3D printing customization was proved to be cost-effective and good cosmetic satisfaction with no complication reported following cranioplasty procedure.

Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency. The location where subdural empyema may appear is a challenge in diagnosis and treatment. We report the case of a 17-year-old boy who presented in a state of somnolence due to interhemispheric and infratentorial subdural empyema with preseptal cellulitis secondary to pansinusitis. Early diagnosis and aggressive antibiotic treatment combined with neurosurgical operation were mandatorily implemented. The case was managed using a multidisciplinary approach including the ENT, eye, and nutrition departments. The boy achieved clinical improvement, with impairment of eye movement as the only persistent symptom before discharge. Daily supervision at the primary health care center with continuous antibiotic treatment was recommended to the patient. Pertinent literature with controversies in the management of subdural empyema will be briefly discussed in this case report.

Highlights Epidural hematoma in pediatric cases due to head fixation pins are rarely reported. The use of pin-type head fixation in pediatric has several different risk factors compared to adult patients. By knowing pre-operative risk factors and early treatment, the outcome will be better.

Laporan keuangan dalam suatu yayasan sangatlah penting terlebih jika dalam bidang pendidikan guna dapat dipertanggungjawabkan kepada pengurus yayasan. Pada TK NU 8 Asshofiyah juga membuat laporan keuangan berbasis buku. Laporan keuangan berbasis buku tersebut bisa dibilang menyusahkan pihak guru maupunpengurus yayasan untuk mengecek arus kas pada saat dibutuhkan sehingga harus dilakukan pembuatan laporan keuangan berbasis digital. Pada era digital sekarang ini laporan keuangan bisa dibuat menggunakan Microsoft Excel guna mempermudah membacanya. Dengan adanya pembuatan laporan keuangan berbasis digital diharapkan para pihak terkait yang membutuhkan tentang arus kas TK dapat dipermudah untuk membacanya.

Traumatic Brain Injury (TBI) case is commonly found in the emergency room. TBI accompanied by increased intracranial pressure (ICP) is a neurological emergency that requires prompt and appropriate management. Hyperosmolar fluid is the main treatment in the initial management of increased ICP. Mannitol and hypertonic saline are hyperosmolar fluids which are generally used. There is no specific recommendation regarding the choice between the two fluids. From the current studies indicate that both fluids are equally effective in reducing ICP. Regarding the superiority between the two fluids, it is difficult to determine because of the heterogeneity of the studies that exist. Therefore, clinicians should choose between hyperosmolar fluids based on indications and contraindications exist in TBI patients.

Introduction Glioblastoma multiforme (GBM) makes 60–70% of gliomas and 15% of primary brain tumors. Despite the availability of standard multimodal therapy, 2 years, 3 years, and 5 years survival rate of GBM are still low. Active immunotherapy is a relatively new treatment option for GBM that seems promising. Methods An electronic database search on PubMed, Cochrane, Scopus, and clinicaltrials.gov was performed to include all relevant studies. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Reported parameters are OS, PFS, AEs, post treatment KPS, and 2 year mortality. Results Active immunotherapy provided better OS (HR = .85; 95% CI = .71–1.01; P = .06) and PFS (HS = .83; 95% CI= .66 – 1.03; P = .11) side albeit not statistically significant. Active immunotherapy reduces the risk of 2 year mortality as much as 2.5% compared to control group (NNT and RRR was 56.7078 and 0,0258, respectively). Conclusion Active immunotherapy might be beneficial in terms of survival rate in patients with GBM although not statistically significant. It could be a treatment option for GBM in the future.