ETV in tuberculous meningitis with hydrocephalus and allergic reaction to VP shunt: a case report

Hydrocephalus is one of the most common complications of tuberculous meningitis (TBM) occurring in up to 85% of patients with the disease. The placement of a ventriculoperitoneal (VP) shunt is the most common form of treatment for hydrocephalus in tuberculous meningitis (TBM). Although allergic reactions to the silicone in shunt device are very rare, the authors describe a case of silicone allergy causing multiple VP shunt revisions. Alternative choice is endoscopic third ventriculostomy (ETV), but it is debatable. ETV has variable success in these patients and is generally not advisable in patients in the acute stages of the disease. A 19-year-old woman with hydrocephalus in tuberculous meningitis, who had undergone multiple VP shunt revisions, presented with shunt malfunction caused by allergic reaction of the tissue surrounding the shunt tubing. Laboratory examination demonstrated high level IgE, high level ESR, and PCR-TBC Positive, related to the allergic reaction. Patient with ETV success score of 50. Patients received ETV and release VSS Shunt. ETV has success in these patients. VP Shunts complications remain a difficult problem in neurosurgical clinical practice. The most typical complications are mechanical obstruction and infection. Allergy to the silicone shunt tubing is quite rare. Silicone allergy is an even more rare occurrence because of its high biocompatibility and low biological reactivity. It is a challenge for ETV when TBM has difficulty to recognize anatomical landmarks on this patient. It could also consider in patients who have shunt failure, and might be a better option than shunt revision

Hubungan Tingkat Pengetahuan Karang Taruna Desa Tentang Cedera Otak Sebelum dan Sesudah Penyuluhan di Desa Pesisir Senggigi

Brain injury has the third largest prevalence of other injuries in Indonesia. Most brain injuries occur on highways as a result of motorcycling accidents. The only effective way to reduce the death rate from brain injury that occurs in motorcycle accidents is to wear a helmet. Cases of brain injury due to traffic accidents are often found in adolescents because of the lack of understanding of the importance of helmet use. Therefore, education is needed about the importance of using standard helmets when driving among teenagers. The counseling activity was carried out in one of the senior high schools (SMA) in Mataram with the dominant target of teenagers using motorized vehicles. The selected high school is SMA Negeri 2 Mataram. The method of implementing this counseling is by giving lectures on brain injury, the mechanism of trauma and brain injury and the importance of using standard head protective equipment (SNI helmets), playing videos about head trauma and interactive dialogue. The mandatory output that will be produced is in the form of research articles in the Unram Medical Journal. In addition, research results will be reported back to related fields as input and study material for traffic safety program activities in determining policies in planning, implementing, and evaluating programs as well as coordinating with related programs and sectors. The researcher will also provide a banner stand regarding the importance of using standard helmets for motorcycle riders at the activity location which can then be used as a medium of communication, information and education to the school students

Penyuluhan Pentingnya Penggunaan Helm Standar Guna Menurunkan Angka Kejadian Cedera Otak di SMAN 2 Mataram

Brain injury has the third largest prevalence of other injuries in Indonesia. Most brain injuries occur on highways as a result of motorcycling accidents. The only effective way to reduce the death rate from brain injury that occurs in motorcycle accidents is to wear a helmet. Cases of brain injury due to traffic accidents are often found in adolescents because of the lack of understanding of the importance of helmet use. Therefore, education is needed about the importance of using standard helmets when driving among teenagers. The counseling activity was carried out in one of the senior high schools (SMA) in Mataram with the dominant target of teenagers using motorized vehicles. The selected high school is SMA Negeri 2 Mataram. The method of implementing this counseling is by giving lectures on brain injury, the mechanism of trauma and brain injury and the importance of using standard head protective equipment (SNI helmets), playing videos about head trauma and interactive dialogue. The mandatory output that will be produced is in the form of research articles in the Unram Medical Journal. In addition, research results will be reported back to related fields as input and study material for traffic safety program activities in determining policies in planning, implementing, and evaluating programs as well as coordinating with related programs and sectors. The researcher will also provide a banner stand regarding the importance of using standard helmets for motorcycle riders at the activity location which can then be used as a medium of communication, information and education to the school students

Relationship between mitotic index and Ki67 expression in meningioma

Background: Meningioma is the most common primary central nervous system (CNS) tumor which covers 36.4% of all CNS tumors. Two important factors determining the prognosis of patients with a diagnosis of meningioma are the percentage of tumor resection and the degree of tumor histopathology. Because there are limitations to routine histopathological examination in predicting tumor progressivity, several examination techniques have been developed including cytogenetics and use of immunohistochemical examination.Method: Observational analytic study was carried out on 68 tumor samples in dr. Wahidin Sudirohusodo Hospital and the Makassar Pathology Diagnostic Center with diagnoses of meningioma from 2012-2018. The Sample size is determined by consecutive sampling method.Results: Sample Size were 68 people from Dr. Wahidin Sudirohusodo Hospital and the Makassar Pathology Diagnostic Center with diagnoses of meningioma which fulfilled the inclusion criteria and consisted of 19(27.9%) men and 49 (72.1%) women with an average age of 42 years. The most common location of the tumor was in the convexity area with an incidence of 29.4%. Grade I meningioma was found 41.2%, grade II of 32.4% and grade III of 26.5%. In grade I, the mean mitotic index was 0.25, grade II was (7.4) and grade III was 22.75. In grade I, the mean Ki67 expression was 1.01%. The highest expression was obtained in grade III with amean of 14.8% and the highest expression was 53%. The Spearman’s rho test results between the mitotic index and Ki67 expression show that there is a positive correlation of 0.490, which means that there is a moderate correlation.Conclusion: IHC expression of Ki67 increases proportionally to the degree of histopathology of meningioma. There is a positive correlation of 0.490 which means that there is a moderate correlation between the mitotic index and Ki67 expression

The effect of progesteron for expression delta (δ) opioid receptor spinal cord through peripheral nerve injury

Abstract Background: Neuropathic pain is a major problem to date because of its high prevalence and lack of effective treatment. Neuropathic pain processes can be influenced by many factors and at various levels of the nervous system, including progesterone and the opioid system. The various mechanisms of the effect of progesterone on pain are still controversial, while the effect of progesterone on the activation of the opioid system also needs to be proven. This study aimed to determine the effect of progesterone on pain through the modulation mechanism of the opioid system. Methods: This research is a completely randomized experimental study using male wistar rats aged around three months at the Experimental Animal Laboratory, Department of Medical Biochemistry, Faculty of Medicine, Airlangga University. Results: The result was analyzed by using statistical analysis of two independent samples (t-test). The t value was obtained at 6.880, p = 0.000 (p < 0.05). Conclusion: It was shown that there was a significant difference in the delta (δ) opioid receptor expression between the control group and the progesterone group, which indicated that progesterone causes an increase in the delta (δ) opioid receptor expression in the spinal cord

Peningkatan Ekonomi Masyarakat Melalui Pemberdayaan Pangan dari Olahan Pisang di Desa Ranggagata Kecamatan Praya Barat Daya Kabupaten Lombok Tengah

In the era of globalization, there can be a process of widening the gap because of the opportunities in this open economy. Therefore, the main thing that must be prevented in globalization is the emergence of this process. Inequality is a real form of development that can be solved by empowering the community, especially for real weak economic actors. Community empowerment is one of the efforts to facilitate local communities in planning, deciding and managing their resources so that in the end they have the ability and independence in an economically, ecologically and socially sustainable manner. Through this empowerment, the community can develop opportunities to show characteristics and be independent to develop their potential. Ranggagata Village is one of the villages located in Southwest Praya District, Central Lombok Regency, West Nusa Tenggara Province, Indonesia. Ranggagata Village has the potential for banana commodities as raw material for processed products but cannot be utilized by the community itself because there are several inhibiting factors, such as the lack of community innovation in making processed products and the lack of interest in community entrepreneurship. The implementation methods used in this activity are socialization, training and mentoring, and evaluation of activities. The results of the activity showed that the community was able to receive the results of the training well, this was proven by their enthusiasm for participating in the activity from beginning to end. From the results of these activities, it can be concluded that the service activities carried out can provide knowledge and skills to entrepreneurs, especially PKK mothers and housewives to produce products that have high selling value

Optimalisasi Potensi Wisata (Gua Sumur, Gua Kelelawar dan Gua Prabu) di Desa Prabu Kecamatan Pujut Kabupaten Lombok Tengah

Tourism is a recreational activity carried out with the intention of breaking away from the daily routine for a while. The tourist village is a combination of natural attractions, culture and creativity of the local community, supported by facilities that can attract tourists to visit the place. Prabu Village is one of the tourist destinations in Pujut District, Central Lombok. Even though it has advantages in natural beauty, unfortunately Prabu Village is still lacking in management and public awareness of the importance of existing tourism potential. Therefore, Unram Thematic KKN participants carried out community service in Prabu village with the theme 'Tourism and the Environment'. The purpose of this service is to introduce the tourism potentials in Prabu Village to the wider community. One of the programs carried out was by making a promotional video for Prabu Village which explained all the potential that the village had. Videos that have been made are then published on various social media (Youtube, Instagram, etc.), websites, and video platforms. With an effective promotional video, Prabu Tourism Village is expected to become an attractive tourist destination for both local and international tourists

TINJAUAN PUSTAKA: DIAGNOSIS DAN TATALAKSANA CEDERA OTAK TRAUMATIK

Abstrak: Tinjauan Pustaka: Diagnosis Dan Tatalaksana Cedera Otak Traumatik. Cedera otak traumatik (COT) merupakan gangguan fungsi otak yang diakibatkan oleh proses mekanik seperti benturan, pukulan atau trauma tembus kepala yang mengenai struktur serebri sehingga menyebabkan terjadinya penurunan kesadaran dan gangguan fungsi otak pada penderitanya. Penyebab terbanyak dari cedera otak terutama pada pria muda disebabkan oleh adanya benturan fisik pada otak seperti terjatuh (35%) dan kecelakaan lalu lintas atau kendaraan bermotor (17%). Penyebab lain yaitu trauma benda tumpul, trauma tembak, kecelakaan saat bekerja, kecelakaan rumah tangga, serta kecelakaan ketika olahraga. Diagnosis cedera otak traumatik diperoleh melalui anamnesis yang menyeluruh untuk memastikan ada atau tidaknya riwayat cedera kepala sebelumnya dan proses terjadinya cedera kepala, gejala klinis yang muncul pada pasien serta hasil pemeriksaan pencitraan dengan CT scan kranial. Tatalaksana pada pasien cedera otak traumatik disesuaikan dengan tingkat keparahan cedera kepala yang dialami. Tatalaksana dapat berupa observasi dan pemberian obat pereda nyeri pada cedera kepala ringan-sedang serta tatalaksana bedah untuk cedera kepala berat

Toward zero mortality in acute epidural hematoma: A review in 268 cases problems and challenges in the developing country

Background: Epidural hematoma (EDH) is one of the most life threatening lesion in patients with craniocerebral trauma. Traumatic extradural haematoma (EDH) is a neurosurgical emergency and timely surgical intervention for significant EDH is the gold standard. This study aims to determine the incidence and mortality of consecutive patients with traumatic EDH admitted to the Emergency Department (ED) of Dr. Soetomo General Hospital, Airlangga University in Surabaya. Material and methods: Retrospective analysis of prospectively collected data for all consecutive trauma cases admitted through the ED during January 2009–May 2012. EDH was diagnosed by CT in all cases. Both primary and delayed onset EDH were included, as were patients with combined EDH and other intracranial lesions (e.g. subdural haematoma). Age, sex, cause of injury, associated intracranial lesions, skull fracture, Glasgow Coma Scale, pupil reactivity, and clinical outcome were determined. Results: We performed a chart review of 268 patients had complete data admitted to the emergency department with EDH diagnosed by CT scan and surgically treated between January 2009 and May 2012, mean of 15.41 patients per month. Seventy (77%) patients were male, with a mean age of 27.1 years. Sixty (73.86%) patients were from road traffic crashes, 40 (14.92%) sustained falls, 7 (2.61%) had direct head trauma. On admission, 81 (30%) patients were GCS 14–15, 116 (43%) GCS 9–13 and 71 (27%) GCS 3–8. Overall, 79 patients (29%) had anisocor pupils. Thirty-one patients (11.56%) died after neurosurgical operation. Conclusions: Outcome of EDH depends on the several factors, including trauma operation interval, patient's age, clinical status preoperative and associated other extracranial injury. Keywords: Extradural hematoma, Traumatic brain injury, Outcom

Intraparenchymal cerebellar capillary hemangioma in a 32-year-old man: a case report

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