Scalenus syndrome is often diagnosed as thoracic outlet syndrome (TOS). We performed literature searching reporting scalenus syndrome and we narratively describe the finding in this review. Scalenus syndrome is a unique clinical entity and commonly occurred. This syndrome can be classified into neurogenic TOS (nTOS) on the interscalene triangle, which also related to myofascial pain syndrome. There are three factors that contribute to scalenus syndrome, which are congenital anomaly, trauma, traumatic myositis, and hypertrophy of scalenus anterior muscle. The symptoms of scalenus syndrome can be divided into two types, which are neurologic and vascular symptoms. The neurologic manifestation can originate from the somatic and sympathetic nervous system. There is microscopic evidence of inflammation, hypertrophy, degeneration, and fibrosis of scalenus anterior muscle in scalenus syndrome cases. Scalenus syndrome can be treated surgically or conservatively. Non-surgical or conservative treatment can be applied to mild scalenus syndrome, especially nTOS, in the initial phase. Surgical management should be performed in persistent symptoms of nTOS or involving subclavian artery manifesting as arterial TOS (aTOS). Scalenus syndrome has quite similar clinical manifestation as nTOS and aTOS. However, this clinical syndrome should be considered as different entity because of different pathophysiology compared to TOS. Scalenus syndrome is caused by dynamic pathology of anterior scalenus muscle.
ABSTRAKDiare masih merupakan penyebab kematian utama pada bayi dan balita. Dilihat dari kelompok umur, diare tersebar di semua kelompok umur dengan prevalensi tertinggi terdeteksi pada anak balita (1-4 tahun) yaitu 16,7%. Berdasarkan data puskesmas Kintamani I pada tahun 2014 dilaporkan mengalami peningkatan sebesar 216 kasus dibandingkan dengan kunjungan tahun 2013. Desa kintamani memiliki angka kejadian diare tertinggi. Prevalensi diare di desa Kintamani meningkat dari 10,5% (2013) menjadi 14,5% (2014). Tujuan penelitian ini adalah untuk mengetahui gambaran perilaku mencuci tangan penderita diare dan non diare desa Kintamani tahun 2015, Kecamatan Kintamani, Kabupaten Bangli. Metode yang digunakan dalam melakukan penelitian adalah rancangan penelitian cross-sectional. Populasi penelitian ini adalah semua orang tua yang memiliki balita di Desa Kintamani. Pemilihan sampel dilakukan dengan teknik multi-stage sampling, dimana sampel merupakan 54 orang tua balita yang tinggal di Desa Kintamani. Analisis penelitian dilakukan secara deskriptif. Hasil dari penelitian menunjukkan perilaku mencuci tangan yang baik memiliki kejadian diare paling sedikit (14,89%), diikuti oleh perilaku mencuci tangan kurang baik (53,8%), dan paling banyak mengalami kejadian diare adalah perilaku mencuci tangan yang buruk (64,3%). Kata Kunci: Karakteristik Umum Responden, Perilaku Mencuci Tangan, Diare, Balita HAND WASHING HABIT IN DIARRHEA PATIENTS AT KINTAMANI VILLAGE BANGLI REGENCY BALI 2015 ABSTRACTDiarrhea is still the leading cause of death in infants and toddlers. Judging from the age group, diarrhea spread across all age groups with the highest prevalence detected in toddlers (1-4 years) is 16.7%. Based on data from the first Kintamani health centers in 2014 reported an increase of 216 cases compared with visits in 2013. Village of Kintamani has the highest incidence of diarrhea. The prevalence of diarrhea in the village of Kintamani increased from 10.5% (2013) to 14.5% (2014). The purpose of this study is to describe hand washing behavior of toddlers' caregiver on diarrhea and non diarrhea toddlers in village of Kintamani 2015, Kintamani, Bangli. The method used in conducting the study is cross-sectional study design. The study population was all parents who have toddlers in the village of Kintamani. Sample selection is done using multi-stage sampling method, where the sample is 54 children of parents who live in the village of Kintamani. The analysis was done descriptively. The results of the study showed good habbit for hand cleaning has the lowest incidence of having diarrhea (14,89%) followed by less good habbit (53,8%) and bad habbit of hand cleaning has the highest incidence for having diarrhea (64,3).
The authors present an unusual case of a 32-year-old adult male with a capillary hemangioma, which developed within the left cerebellar parenchyma. The histopathological examination reveals a mass mostly formed by the proliferation of capillaries, lined by a layer of flat-plump endothelial cells, some branching and dilating large capillaries, forming a lobulated structure separated by fibrocollagenous connective tissue. Immunohistochemistry examination with CD31 and S100 was positive on the endothelial and stromal cells, respectively, and negative S100 on the endothelial cells. Although rare, capillary hemangioma should be one of the differential diagnoses for diagnosing intra-axial lesions in the cerebellar region. Confirmation of the histopathological characteristic is necessary to determine the diagnosis of capillary hemangioma and exclude other differential diagnoses.
BACKGROUND: Acute subdural hematoma (ASDH) is a major problem in traumatic brain injury. Surgical techniques for treating ASDH are varied, including cranioplastic craniotomy and large decompressive craniectomy. The superiority of craniectomy and craniotomy for treating ASDH is still controversial. AIM: The aim of this study was to compare the clinical outcome between craniectomy and craniotomy for treating traumatic ASDH through systematic review and meta-analysis. METHODS: This study used electronic articles published in PubMed, EBSCO, Google Scholar, and Directory of Open Access Journal. Articles included were full-text observational studies in Indonesian or English. Clinical outcome using the Glasgow Outcome Scale was compared between craniectomy and craniotomy. Statistical analysis was done using Review Manager 5.3. RESULTS: Six articles met our inclusion and exclusion criteria. We performed random effect model analysis because of high heterogeneity between studies (I2 = 77%; X2 = 21.98). The pooled risk ratio between craniectomy and craniotomy on poor outcomes was 1.41 (p = 0.02; 95% CI: 1.06–1.88). CONCLUSION: Craniectomy increases the risk of poor clinical outcomes in treating a traumatic ASDH.
Introduction: Filum terminal is a fibrous tissue to stabilize the position of the spinal cord, located in both intradural and extradural sections anchored caudally to the coccyx. Tumors located at the filum terminal are a rare case. Filum terminal does not have any spinal cord component, but tumours in that area can directly cause a significant neurological disorder. Case Presentation: Presenting 43 years old man with chief complaints of drop left foot and tethered cord syndromes. MR Image revealed 9,4x10mm intradural extramedullary mass at L1 with L1-L5 disc desiccation. The patient was untethered by laminectomy and underwent total mass excision. The sample was analyzed pathologically, and the results matched myxopapillary ependymoma. Pain sensation and sensory disturbance immediately improved after surgery. The urinary disorder also gradually improved. The patient was discharged without any urinary problems. After six months of follow-up, painless, mild left lower drop foot and mild gait disturbance was found without residual urinary and other neurological disorder. Conclusion: Filum terminal ependymomas need to be considered for differential diagnoses in patients with drop foot and adult-onset tethered cord syndromes.
Peningkatan jumlah penduduk diikuti peningkatan jumlah kendaraan bermotor sehingga meningkatkan kemungkinan terjadinya kecelakaan lalu lintas. Selain kematian, permasalahan lain yang ditimbulkan oleh kecelakaan adalah cedera tulang belakang. Cedera tersebut tidak hanya membebani kesehatan melainkan juga mempengaruhi sisi ekonomi, hubungan sosial, dan psikologis seseorang. Ilmu Bedah Saraf menerapkan prinsip ilmu dengan aspek komprehensif dan holistik. Prinsip komprehensif berarti ilmu ini tidak hanya menekankan sisi kuratif, tetapi juga pada promotif, preventif, dan rehabilitatif. Salah satu upaya kegiatan promotif dan preventif yang dapat dilakukan adalah memberikan edukasi kepada masyarakat mengenai pola – pola hidup sehat sehingga masayarakat dapat terhindar dari suatu kondisi yang menyebakan morbiditas. Kegiatan Bedah Saraf Bersama Masyarakat Program Studi Spesialis Bedah Saraf FK UNUD/ RSUP Sanglah merupakan salah satu kegiatan pengabdian kepada masyarakat. Dalam upaya mencegah terjadinya cedera tulang belakang pada pemobil, Program Studi Spesialis Bedah Saraf FK UNUD/ RSUP Sanglah kali ini mengadakan penyuluhan pentingnya penggunaan seatbelt pada pemobil. Tujuan umum kegiatan ini adalah memberikan informasi dan edukasi terutama pencegahan mengenai penyakit – penyakit di bidang keilmuan bedah saraf kepada masyarakat umum. Kata kunci : Tulang belakang, cedera tulang belakang, penyuluhan kesehatan, sabuk pengaman.
Spinal tumors found in about 5-15% of the central nervous system neoplasm. Intradural-extramedullary spinal cord tumors are one of the types that usually managed with total laminectomy but with many postoperative complications. A 76-year-old woman with paraplegia caused by intradural-extramedullary intraspinal tumor at thoracic 4 level. For this patient, we performed unilateral laminectomy without any fusion or stabilization from the left side then we performed total excision of the tumor. The surgery was successfully done with fast improvement of patient condition, minimal pain after surgery, no blood transfusion needed, shorter intensive care period needed, and fast recovery time are the prominent things in this case. Three days after surgery, the patient’s motoric power already improved and then the patient is permitted to go home at the fifth day.
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