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Interdural Spinal Arachnoid Cyst Case Study and Review of Literature with Operative Technical Considerations
No full textIntroduction
Spinal arachnoid cysts are commonly encountered throughout all age groups and are often managed observantly, but a minority cause symptoms requiring intervention. These cysts can be caused by congenital malformations, trauma, inflammation, or even occur spontaneously. A vast majority of arachnoid cysts in the spine are extradural, and about 10% are intradural. One type of intradural cyst occurs between two leaflets of the dura, described as an interdural cyst.
Case Report
This case report describes a 47-year-old female with an interdural arachnoid cyst spanning the thoracolumbar region (T11-L3). Initially, the patient was asymptomatic but later presented with progressive neurologic symptoms, including intermittent back pressure, heaviness in her legs, paresthesia, urinary hesitancy, and decreased sensation in the perineal area. Surgical intervention via direct lumbar laminectomy was performed from the bottom of T11 to the top of L3, revealing an interdural cyst without communication to the subarachnoid space. Thus, surgical fenestration was performed to establish a pathway between the cyst and the subarachnoid space to alleviate symptoms and prevent recurrence.
Discussion
The absence of communication between the cyst and the subarachnoid space suggests alternative mechanisms, such as a ball valve mechanism, contributing to cyst expansion. A comprehensive review of existing literature on interdural cysts underscores the necessity for revised classification systems, considering both their fluid content and communication with the subarachnoid space.
Conclusions
The proposed classification of interdural cysts based on CSF analysis and connection to the subarachnoid space may guide operative management and provide more information on the etiology. This classification system could refine outcome data in the operative management of interdural spinal cysts
Trends in Antibiotic Resistance in Infected Wounds: A Retrospective Analysis at the National Research Center for Traumatology and Orthopedics Named After Academician N.D. Batpenov (2021-2023)
No full textThe increasing incidences of antibiotic-resistant infections is a significant concern in managing complicated wound healing. This study examines the trends and microbiological profiles of infected wounds treated surgically at the National Research Center for Traumatology and Orthopedics named after Academician N.D. Batpenov in Astana, Kazakhstan, from 2021 to 2023. A retrospective analysis was conducted on patients who underwent surgical wound closure between 2021 and 2023. Data on patient age, length of hospital stay, comorbidities, type of trauma, chronicity of the condition, affected body part, initial diagnosis, and microbiological culture results were collected. The study assessed the frequency and patterns of antibiotic resistance among isolated pathogens. In 2021, 56 patients were included, with an average age of 43±14.7 years and an average hospital stay of 22.25±11.6 days. Trauma types varied, with a significant proportion resulting from traffic accidents and burns. In 2022, 21 patients (average age 43.9±12.2 years) had longer hospital stays (37.5±23.4 days). The primary diagnoses included osteomyelitis and acute injuries. In 2023, 33 patients were studied, with a mean age of 42.5±27 years and an average stay of 12.6±11 days. Notably, the proportion of patients with osteomyelitis increased over the 3 years. Microbiological analysis revealed a growing presence of antibiotic-resistant pathogens. Staphylococcus aureus (24%) and Pseudomonas aeruginosa (12%) were the most commonly isolated bacteria, with a significant increase in resistance to beta-lactams and other antibiotic groups. The emergence of multi-drug resistant Klebsiella pneumoniae and Acinetobacter species was also observed. The study highlights a concerning trend of increasing antibiotic resistance in pathogens isolated from infected wounds. This underscores the need for ongoing surveillance, updated treatment protocols, and the judicious use of antibiotics to manage such infections effectively. Further research is required to develop strategies to combat the rise of antibiotic-resistant infections
Avoidable Mortality from Cardiovascular Disease in Aktobe Region
No full textIntroduction: Avoidable mortality, which can be categorized as preventable or treatable mortality, can be used to assess the performance of a healthcare system and identify priority interventions. The aim of this study is to examine mortality rates from cardiovascular disease (CVD) in Aktobe, Kazakhstan.
Materials and Methods: We extracted data from the National Research Center for Health Development in the Aktobe region by urban and rural areas. The calculations took into account the population’s age and mortality rates from chronic rheumatic heart disease (I05-I09), hypertension (I10-I15), ischemic heart disease (I20-I25), and cerebrovascular diseases (I60-I69) from 2019 to 2023, broken down by gender and 5-year age groups (0, 1–4, 5–9, to 71-74). Joinpoint regression is used to identify the average annual percentage change (AAPC).
Results: Avoidable mortality from CVD increased between 2019 and 2021, followed by a sharp decrease to 95.49 in 2022 and then to 96.19 per 100,000 people. Avoidable mortality was higher in rural areas and among males. Treatable mortality in the region was higher than preventable mortality. The leading causes of avoidable CVD were ischemic heart disease and cerebrovascular diseases. The AAPC of avoidable mortality from CVD in the Aktobe region was 2.1 (-29.7; 48.2), whereas treatable mortality was 2.4 (-29.0; 47.6), and preventable was 1.7 (-30.6; 48.9). The absolute change for avoidable mortality related to CVD was 16.96 per 100,000 people.
Conclusion: Our data indicate the need to strengthen work in hospitals and secondary prevention, as there is a high treatable mortality rate, especially in rural areas. Additionally, the high level of avoidable mortality rates among males indicates the need for a more in-depth analysis of the causes, particularly for ischemic heart disease and cerebrovascular diseases
Spontaneous Spinal Epidural Hemorrhage Following Intravenous Thrombolysis: A Systematic Review of Case Reports
No full textBackground: Spontaneous spinal epidural hematoma (SSEDH) is a rare condition typically occurring in adults aged between 40 and 50 years. The condition can eventually evolve into neurological deficits that result in motor and sensory loss. Tissue plasminogen activators are Food and Drug Administration-approved drugs for various vascular thrombotic diseases including myocardial infarction and acute ischemic stroke. This review seeks to examine the available literature regarding the SSEDH following thrombolytic therapy.
Method: A total of 21 papers underwent screening for eligibility criteria and subsequent evaluation led to the extraction and qualitative synthesis of data from 12 selected papers. The gathered information encompassed patients’ demographic details, primary diagnoses, types of thrombolytic therapy administered, neurological presentations, treatment modalities employed, and ultimate outcomes.
Results: This analysis delves into 13 cases of SSEDH following intravenous thrombolysis, encompassing patients aged 39 to 75 years across diverse global regions. The study revealed that eight out of 13 cases were male and nine were above 50 years old. Neurological symptoms, diagnosed via MRI or CT, manifested within 30 minutes to 48 hours post-therapy, with 76.92% occurring within the initial 24 hours. Bleeding occurrences were notably frequent across the combined cervical and upper thoracic spinal regions (cervico-thoracic), similar to their frequency in the isolated lumbar area (23.08% each). Myocardial infarction (MI) accounted for 69.2% of thrombolytic administrations.
Conclusion: Spontaneous spinal epidural hematoma is a rare but serious complication that can occur following thrombolytic therapy with tissue plasminogen activators (tPA). Our review of 12 case reports reveals that SSEDH, although infrequent, often develops within 48 hours of treatment, particularly in patients over 50. The potential link between tPA and SSEDH emphasizes the need for careful monitoring and early imaging. Further research through prospective, multicenter studies is crucial to clarify this association and enhance patient care, highlighting the importance of vigilance in managing thrombolytic therap
The Role of Biochar Towards Sustainability and Remediation of the Agricultural Environment in Developed and Developing Countries - A Review
No full textThe earth is drastically facing different types of environment sustainability issues due to burning of waste, industrial, automobile, addition of inorganic pollutants and anthropogenic activities. The addition of toxic pollutants in the environment produce significant impact on plant and human life. Biochar is a carbonaceous material and obtained from the thermal treatment of biomass (pod, leaves, twig, peel waste), agricultural, urban green waste and animal wastes and found all around the world. Biochar is also a good source of mineral nutrients and with the passage of time easily leached out in the environment. The biochar positively improve the physicochemical properties of soil and environmental quality. The application of biochar at low level leads to improvement in crop productivity and at higher concentration become toxic to plant growth. The constant release of different types of pollutants likewise sludge, municipality waste, and specially heavy metals into the environment causes serious metals pollution problems in air, water and soil on a global scale in recent years alarmingly. The addition of metallic element into the environment become environmental risks, and influence on plant growth and soil properties. The interactions of biochar with immediate environment decrease the chances of environmental risk contamination. Biochar adsorb heavy metals from the soil due to its unique structure and composition. Biochar materials have been successfully used to adsorb contaminants from the environment and few studies have been documented by different researchers both in national and international scientific journals. The objective of the present review was to summarize, analyze and focused on understanding about the potential role of biochar on soil health, crop nutrition, carbon management, climate change, crop yield management, and heavy metals absorbents. The sustainable use of biochar in industrial and agricultural sector can helps in improving soil quality, plant growth and in controlling the critical environmental issues specially metal contamination
Modern Approaches to Assessing the Effectiveness of the Sanitary and Epidemiological Surveillance Service: Literature Review
No full textExamining how the effectiveness of health and epidemiological authorities is assessed today. As it explores contemporary techniques developed by scholars in this field to monitor and control disease outbreaks effectively However, it is not only an ageold problem that ails modern society. In just the past few years, parkinson’sUnlikelier collaborations can be found in the private and public fields of business, in academics and professionals everywhere or at gatherings between partners from two or more government institutions. Interagency cooperationIn reviewing the existing potential for academic research in this area it is important to bear in mind that various centers have unique attributes and strengths since they owe their existence largely to differences at both the trans- and international levels
Financial Literacy and Symbolic Capital in Improving the Performance of MSMEs
No full textSemarang city is home to 84 MSMEs under the guidance of PTPN IX. These small-scale businesses face significant challenges related to financial literacy and performance, including limited understanding of financial management, investment strategies, debt management, long-term financial planning, and the ability to leverage financial opportunities. This investigates the impact of financial literacy on MSME performance, with symbolic capital serving as a mediating variable. A quantitative approach was employed, using both primary and secondary data collected through questionnaires distributed to all 84 MSMEs supported by PTPN IX located in Semarang. A saturated sampling method was used. Data were analyzed using SEM-PLS, involving two stages: (1) measurement model testing to assess the validity and reliability of construct indicators, and (2) structural model testing to examine relationships among constructs using PLS t-test. The results indicate that symbolic capital fully mediates the relationship between financial literacy and MSME performance, suggesting that financial literacy indirectly influences performance through symbolic capital. These findings highlight the importance of enhancing financial literacy among MSME owners to build symbolic capital, which in turn can improve overall business performance
Green Hiring and Employee Innovation in Sustainable Organizations
No full textThis research aims to further explore the impact of Green Human Resource Management (GHRM) practices on green innovative work behavior at Bank Syariah Indonesia. GHRM practices include green hiring, green training, and green compensation, all of which are designed to foster environmentally responsible behavior that supports sustainability. Employees can embody the company’s green values by maintaining an eco-friendly workplace. The study sample consists of employees from Bank Syariah Indonesia, and the analysis is conducted using a structural equation model (SEM) with AMOS. Based on the literature review, GHRM, which encompasses green hiring, green training, and green compensation, has a positive and significant impact on innovative work behavior and enhances organizational performance. Organizations that implement GHRM should prioritize environmental sustainability and adopt green hiring, training, and compensation strategies for their employees. GHRM offers numerous benefits, one of which is improved employee performance
Islamic Populism as Identity Politics: Dynamics and Challenges in Indonesian Democracy
No full textIslamic populism has grown rapidly in Indonesia as one manifestation of political identity that plays an important role in the dynamics of democratic politics. This phenomenon is considered a form of dissatisfaction of some Muslim communities with political and economic structures that are considered unfair and elitist. Islamic populism emphasizes the dichotomy between the holy group (ummah) and marginalized groups that face the political elite who are considered corrupt and do not represent the interests of the majority. The purpose of this article is to examine the development of Islamic populism in the context of Indonesian democracy, with a focus on how religion is used as a tool for political mobilization and the formation of collective identity. This study uses qualitative and quantitative approaches involving the analysis of various political events, including the 2014 and 2019 General Elections, the 2017 Jakarta Gubernatorial Election, and social movements such as the 411 and 212 Islamic Defense Actions. Quantitative data from research institutions such as LSI, SMRC, and political indicators Indonesia are used to measure public perceptions of politics based on religious identity and show a significant increase in preferences for identity politics among the Muslim community. This article also discusses the main challenges faced by Indonesia in managing Islamic populism, in line with the principles of integrative and pluralistic democracy. The results of this study are expected to contribute to academic understanding and become a guide in responding to the dynamics of Islamic identity politics in the era of modern democracy in Indonesia
Mapping Publication Trends on Governance Capacity in Tourism Development: A Systematic Literature Review
No full textThis study aims to map the development of research and scientific publications on capacity governance in tourism development. It uses a systematic literature review approach to analyze 46 scientific articles selected based on PRISMA procedures. The articles were sourced from the Scopus database published in the 2019–2024 period and analyzed with Vosviewer. The results reveal six topic clusters in the study of capacity governance towards tourism development, namely government, integration, sustainable tourism development, tourism sector, governance arrangement, and destination governance. Government is the most dominant cluster compared to other clusters, which indicates that it is a general concept used in the study of capacity governance in tourism development, and is related to various issues in other clusters, including sustainable development, tourism policy, policy implementation, destination governance, and destination development. This research contributes to the development of capacity governance studies in tourism development, sustainable tourism development, and destination governance. The limitation of this research is that the data used is only sourced from the Scopus database, so the results cannot explain the study of social movements on social media as a whole. Therefore, future research needs to use data or references from various reputable databases like Web of Science and EBSCO