The Cervical Spinal Epiduritis, pertaining to Diagnosis, Treatment, and Outcomes: on severe spinal cord stenosis. A Case Report and a Literature Review: Cervical Spinal Epiduritis, pertaining to Diagnosis, Treatment, and Outcomes

Abstract Background: Osteomyelitis coupled with immunocompromised people with drug or intravenous drug use produces infective endocarditis. Remember that atlantoaxial subluxation accompanied by infection of the pharynx or nearby tissues is termed Grisel syndrome. [2]. Epidural abscesses are sometimes surgical emergencies, depending on the type of neurological impairments. An upper cervical epidural abscess in the occiput at the level of C2 is highly rare and uncommon. At the level of the subaxial spine at C3-C6 OR C7-T1 is the cervicothoracic area. Case Presentation A 54-year-old female patient reported experiencing cough and catarrhal symptoms for three months due to a previous coronavirus infection, accompanied by shortness of breath and joint pain. The patient's neck pain intensified, radiating to the left arm (myelopathy); conservative treatment was ineffective. MRI of the cervical spine indicated purulent spondyloarthritis affecting the left C4-C6 facet joints, with severe spinal cord stenosis (Figure 1), accompanied by epiduritis in the adjacent segment and abscess formation in the posterior paravertebral muscles of the neck. The surgical intervention consisted of a left C5-C6 hemilaminectomy with a microdiscectomy with which a metal cage was placed after sanitation and drainage of the purulent epiduritis, approach to the spondyloarthritis in the C4-C6 segments, and management of an intermuscular abscess with a cage. Conclusion Our clinical case shows a cervical spinal epiduritis with spinal cord stenosis, confirmed by imaging; therefore, once the diagnosis was confirmed, the decision was to perform an eminent surgical intervention with a hemilaminectomy and microdiscectomy.&nbsp

Correlation between Physical Activity and Happiness: A Cross-Sectional Study in Medan

Introduction: Physical activity contributes to mental well-being by stimulating neurotransmitters associated with pleasure and positive mood. Understanding this relationship within specific populations is important for promoting community health. Objective: This study aimed to evaluate the correlation between physical activity and happiness among residents of Medan, Indonesia. Methods: This cross-sectional study was conducted in Medan from May to November 2021 and involved 260 participants. Physical activity was assessed using the International Physical Activity Questionnaire, while happiness and affect were measured using the Oxford Happiness Questionnaire and the Positive and Negative Affect Scale. Data were analyzed using Spearman’s rank correlation test. Results: Overall physical activity was positively correlated with happiness (r = 0.132; p = 0.034) and positive affect (r = 0.214; p = 0.001). Vigorous physical activity showed positive correlations with happiness (r = 0.185; p = 0.003) and positive affect (r = 0.244; p = 0.001). Walking was also positively correlated with happiness (r = 0.132; p = 0.034) and positive affect (r = 0.214; p = 0.001). Moderate physical activity was not correlated with happiness (r = –0.017; p > 0.05) or positive affect (r = 0.065; p > 0.05). No correlation was found between physical activity and negative affect. Conclusions: Physical activity is positively correlated with happiness among residents of Medan

Gadget Usage and Its Relationship with Mental and Emotional Health in Early Childhood (3–6 Years) at Puskesmas Medan Tuntungan

Introduction: Excessive gadget use in early childhood is increasingly associated with cognitive, behavioral, and emotional problems. Preschool-aged children are particularly vulnerable as this period involves rapid socio-emotional and motor development. Objective: This study aimed to determine the association between gadget use and mental and emotional health among children aged 3–6 years at Puskesmas Medan Tuntungan. Methods: A cross-sectional study was conducted involving 105 children selected through consecutive sampling. Data on gadget use (duration, type, ownership, and age of first exposure) were collected using parent-reported questionnaires. Mental and emotional status was assessed using the KMME instrument. Bivariate analysis was performed using the Chi-square test with a significance level of p < 0.05. Results: Most children (61.90%) used gadgets for more than one hour per day, exceeding recommended limits. A total of 64 children (60.95%) screened positive for mental and emotional problems. Screen time >1 hour was significantly associated with mental–emotional problems (p = 0.001). No significant relationship was found between personal gadget ownership and mental–emotional problems (p = 0.729). Conclusion: Longer screen time, particularly >1 hour per day, was significantly associated with mental and emotional problems in preschool-aged children. Further longitudinal studies with larger samples are needed to strengthen causality and generalizability

Global Ischemic in A 3-Months-Old Child with Hydrocephalus : A Case Report of Good Outcome

Introduction. Ventriculomegaly causes compression within the cranial vault, which increases intracranial pressure and leads to severe brain damage. Usually progressive. if untreated, may be fatal. Case. 3-month-old male child with increasement of head circumference for 2 months. Fever, cough, cold, vomiting, seizure was not found. MRI show extensive dilatation of ventricular system wide-open foramen of Luschka and Magendie with thinning of cerebral cortex and also global ischemic hypoxia. Discussion. The CBF is regulated by the Monroe-Kellie doctrine which state that space of the cranial cavity is fixed in volume. Congenital hydrocephalus occurs in one in 500-1000 babies born in the United States. Lipid peroxides, formed by oxygen free radical damage to membranes, have been detected in hydrocephalic brains by detection of thiobarbituric acid reactive substances. The mechanism of periventricular axon damage includes calcium mediated activation of proteolytic calpains that damage cytoskeletal proteins, similar to the processes that follow acute traumatic or ischemic injury. The gold standard permanent treatment for hydrocephalus is CSF diversion by placement of a shunt. A shunt has three basic component parts: a ventricular catheter placed in the lateral ventricle, a valve regulating the flow of CSF out of the brain, and a distal catheter that terminates in a cavity. The most common shunt, a ventriculoperitoneal shunt (VPS), has been well accepted since its inaugural use. Surgical treatment is associated with a 50% reduced risk of death overal

Effectiveness of School Feeding Programs on Student Participation and Academic Performance in Selected Schools of Sri Lanka

Background: School nutrition programs are recognized for improving students’ health, yet their direct contribution to educational outcomes, particularly in remote and low-income junior secondary schools, remains insufficiently explored. Objective: This study investigates how school feeding programs influence student participation and academic performance. Methods: A mixed-methods explanatory design was used to compare schools with and without feeding programs. The sample consisted of 110 students, 25 teachers, and 20 parents from four socioeconomically diverse schools. Data were collected over three months through surveys, structured interviews, classroom observations, and analysis of attendance and academic records. Results: Findings indicated a 20% reduction in absenteeism and a 15% increase in average test scores in schools implementing nutrition programs. Students reported improved concentration and engagement, and teachers observed enhanced participation and fewer behavioural issues. Conclusions: School nutrition programs significantly support student learning and attendance. Integrating and expanding such initiatives, particularly in underserved areas, may further strengthen academic outcomes and overall student development

Renal Function and Left Ventricular Ejection Fraction in Diabetic Patients with Acute Heart Failure

Background: Acute heart failure (AHF) in patients with type 2 diabetes mellitus (T2DM) is frequently complicated by renal dysfunction, which may aggravate cardiac impairment. Serum creatinine may reflect this cardio–renal interaction, but its association with left ventricular ejection fraction (LVEF) in AHF patients with T2DM remains unclear. Objective: To investigate the correlation between serum creatinine and left ventricular ejection fraction (LVEF) in patients with acute heart failure (AHF) and type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study of 52 hospitalized AHF patients with T2DM. Clinical data, serum creatinine, A1C, and echocardiographic LVEF (assessed by two independent consultants) were collected. Correlation and multivariable linear regression analyses were performed. Results: The patients were middle-aged and predominantly male. Mean LVEF was 33.2 ± 9.1%, and mean serum creatinine was 1.58 ± 0.31 mg/dL. Higher serum creatinine levels were strongly associated with lower LVEF. Glycemic status (A1C) and urea levels also showed negative associations with LVEF. After adjustment, serum creatinine and A1C remained independent predictors of reduced LVEF. Conclusion: In AHF patients with T2DM, higher serum creatinine and A1C levels are independently associated with reduced LVEF, underscoring the cardio-renal-metabolic interplay in this population and highlighting the need for integrated management strategies

Correlation Between Platelet Distribution Width and Mean Platelet Volume with Hematocrit in Dengue Hemorrhagic Fever Patients at Prof. Dr. Chairuddin Panusunan Lubis Hospital Universitas Sumatera Utara

Background: Dengue Hemorrhagic Fever (DHF) is a dengue virus (DENV) infection through the bite of an infected mosquito that manifests clinically in the form of high fever, headache, muscle pain, nausea, and rash. Research shows that several regions in Southeast Asia, including Indonesia, will experience an increase in the incidence of dengue infection in 2050 and 2080. Objective: This study aims to determine the correlation between platelet distribution width (PDW) and mean platelet volume (MPV) with hematocrit (Hct) in patients with Dengue Hemorrhagic Fever (DHF) at the Prof. Dr. Chairuddin Panusunan Lubis Teaching Hospital, Universitas Sumatera Utara. Methods: This study was conducted with a cross-sectional design. The subjects of this study were 142 DHF patients aged > 17 years obtained from medical record data at the Prof. Dr. Chairuddin Panusunan Lubis Hospital, Universitas Sumatera Utara. Statistical analysis using the Pearson Correlation Test. Results: In 142 study subjects, it was found that the majority of patients were in the age range of 18-39 years (83,8%) and were male (51.4%). The majority of patients had normal PDW values ​​(85.2%), normal MPV values ​​(91.5%), and normal hematocrit values ​​(59.1%). Conclusion: No significant correlation was found between PDW and MPV with Hct in DHF patients

Characteristics of Neonatal Intracranial Hemorrhage at RSUP Haji Adam Malik during the Year 2022-April 2025

The neonatal state is a vulnerable period where rapid physiological transitions happen. In Indonesia, in the year 2020, the Infant Mortality Rate was 19.83 per 1,000 live births, including a Neonatal Mortality Rate of 9.30. This state is also a part of the critical period of a postnatal brain development. Disruption to the brain during this time window can cause problems in the neurodevelopmental process. One of the examples being intracranial hemorrhage in neonates, which the true prevalence and incidence rates of are unclear, but which have high mortality and morbidity rates. The objective this study is to determine the characteristics of neonatal intracranial hemorrhage at Haji Adam Malik General Hospital in 2022-April 2025. This study used a descriptive design through a retrospective cross-sectional study and a sample of neonates with intracranial hemorrhage at Haji Adam Malik General Hospital through saturated sampling. It was found that incidence rate was 6.24 per 100, with the most common bleeding location being intraventricular 25 (89.3%), the majority of neonates were premature, namely 19 (67.9%), low birth weight 19 (67.9%), the most common symptoms were seizures and respiratory distress 15 (53.6%), and 11 (39.3%) neonates made a good recovery

Factors Contributing to Sphenoid Sinus Volume and Its Relation to Isolated Fungal Sphenoid Sinusitis

Background: Isolated Sphenoid Sinus disease is an uncommon entity, with fungal sinusitis being identified as its most common cause. Objective: We investigate factors affecting sphenoid sinus volume (SSV), its pneumatization type, aeration path to the SS ostium, and its relation to isolated fungal sphenoid sinusitis (IFSS). Methods: A total of 43patients with a mean age of 66.6years, histopathologically diagnosed with IFSS, were included in this study. Demographics recorded were age and gender, parameters affecting sinus volume, obstruction of the pathway to the SS ostium, and types of SS pneumatization. The SSV of the pathological and normal sides of the patients was compared. Parameters affecting the incidence of IFSS were evaluated. Results: Presence of lateral recess pneumatization (LRP) and post-sellar type of SS pneumatization significantly increases SSV(p<0.05). There is no significant correlation between SSV and the incidence of IFSS (p=0.815). Obstruction of the airway path to the SS ostium and post-sellar type of SS pneumatization significantly increases the incidence of IFSS (OR = 21.021, p = 0.014; OR =13.59, p=0.02). Conclusion: SSV increases in the presence of LRP, sellar, and post-sellar type of pneumatization. Incidence of IFSS is independent of SS volume. Post-sellar type of SS pneumatization and an obstructed path to the SS ostium increase incidence of IFSS

Late Detection with Claw Hand Deformity in a Leprosy Person: A Case Report

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It remains a major public health problem and is often neglected, especially in remote communities. Objective: This case report describes a patient with late detection of multibacillary leprosy who presented with advanced deformity, and highlights the factors contributing to delayed diagnosis. Methods: A clinical assessment and detailed history were conducted on a 78-year-old man from the Orang Asli community in Pekan, Pahang. The diagnosis was made clinically and later confirmed through a skin slit smear with acid-fast staining. Disability grading was performed according to the World Health Organization criteria. Results: The patient presented with a left claw hand deformity that had progressed for two years without treatment, accompanied by ulceration and sensory loss. He was classified as having grade 2 deformity. Multidrug therapy (MDT) was started promptly at the primary care clinic, and his symptoms improved after treatment initiation. Stigma and low awareness of leprosy were identified as the main factors contributing to the delay in seeking care. Conclusion: This case illustrates the consequences of late detection of leprosy, which can lead to permanent disability. Early recognition and prompt initiation of MDT remain essential to prevent progression and reduce disability, especially in underserved communities