TRANSPUBLIKA INTERNATIONAL RESEARCH IN EXACT SCIENCES

Comparative Outcomes of Posterior Spinal Fusion and Vertebral Body Tethering in Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Systematic Review and Meta- Analysis

2026-01-05T03:30:35+00:00

Adolescent scoliosis requiring surgical correction is commonly treated with posterior spinal fusion, a procedure that provides reliable deformity correction but reduces spinal mobility. Vertebral body tethering has emerged as a motion-preserving alternative, yet its comparative effectiveness and long-term safety remain uncertain. This systematic review and meta-analysis aimed to evaluate the radiographic, perioperative, functional, and safety outcomes of fusion and tethering techniques in adolescents with scoliosis. A comprehensive search of major databases identified eleven comparative studies that met the inclusion criteria. Pooled analyses demonstrated that fusion achieved superior radiographic correction, including lower final curve magnitudes and greater percentage and absolute curve correction. Tethering showed perioperative advantages, such as shorter operative time, reduced blood loss, and shorter hospital stay, while patient-reported outcomes were generally similar between techniques. However, tethering was associated with significantly higher complication and revision rates, primarily related to mechanical failure of the tether construct. Overall, these findings suggest that tethering may offer short-term recovery benefits for selected skeletally immature patients, whereas fusion remains the more predictable and durable option for achieving optimal curve correction. Further long-term comparative studies are needed to clarify the appropriate clinical role of tethering in the surgical management of adolescent scoliosis.

Cutaneous Larva Migrans on the Dorsum of the Foot in a Rural Primary Care Setting: A Case Report from Sintang, West Borneo

2025-12-06T08:20:54+00:00

Cutaneous larva migrans (CLM), commonly termed creeping eruption, is a zoonotic dermatosis resulting from the intraepidermal migration of filariform hookworm larvae, predominantly originating from dogs and cats, and is endemic to tropical and subtropical areas characterized by warm, humid, sandy environments. This report delineates the clinical manifestations, predisposing factors, and therapeutic approaches to CLM in a rural primary care context, aiming to enhance prompt identification and appropriate management. A 45-year-old woman presented with intensely pruritic, erythematous, serpiginous papules on the dorsum of her right foot that had progressively extended over a two-week period. She reported frequent barefoot work in agricultural fields and residence in an area with numerous free-roaming dogs and cats. Physical examination revealed multiple linear, winding erythematous tracks on the dorsum pedis dextra, consistent with CLM. The patient was treated with oral albendazole, ethyl chloride spray, and an oral antihistamine, along with counseling on personal and environmental hygiene. Pruritus significantly improved within one week, and the skin lesions resolved completely within two weeks. This case highlights the critical importance of identifying the distinctive clinical features of CLM and implementing prompt treatment, particularly in resource-constrained rural settings, as early diagnosis and appropriate management can result in rapid symptom resolution and avert avoidable complications.

Morphological Characteristics of Plants in Compound Leaves

2026-03-05T09:29:52+00:00

Plant morphology is a branch of biology that examines the physical forms, structures, and characteristics of plants. Compound leaves, defined as leaves bearing more than one leaflet on a single petiole, exhibit considerable morphological diversity across species. This study aimed to identify and compare the morphological characteristics of compound leaves from four plant species, namely cassava (Manihot esculenta), moringa (Moringa oleifera), starfruit (Averrhoa bilimbi L.), and sensitive plant (Mimosa pudica), with a focus on distinguishing the main petiole, leaflet stalk, and leaflet arrangement of each species. Morphological observation was conducted through direct visual examination of fresh leaf specimens, recording characteristics including leaf type, leaflet shape, venation pattern, surface texture, and leaflet arrangement along the rachis. The findings revealed distinct morphological profiles among the four species. Cassava leaves were identified as palmate compound leaves with 3-8 finger-like leaflets radiating from the tip of the main stalk. Moringa leaves were classified as triply odd-pinnate compound leaves with small, oval leaflets arranged alternately along the rachis. Starfruit leaves were identified as odd-pinnate compound leaves consisting of 21-24 pairs of oval leaflets with pinnate venation and a finely hairy surface. Sensitive plant leaves were identified as bipinnate compound leaves whose leaflets fold upon physical contact. It can be concluded that each species exhibits a unique combination of compound leaf morphological traits that serves as a reliable basis for visual identification and reflects functional adaptation to the respective plant's ecological environment.

Management Challenge of Culture-Negative Infective Endocarditis in an Adolescent with Uncorrected Patent Ductus Arteriosus: A Case Report

2026-04-06T13:42:06+00:00

Infective Endocarditis (IE) remains a life-threatening complication for patients with uncorrected Congenital Heart Disease (CHD). This case report illustrates the complex clinical management of a 39 kg pediatric patient presenting with a five-day history of fever and acute heart failure. Clinical examination and Transthoracic Echocardiography (TTE) confirmed the presence of a Patent Ductus Arteriosus (PDA) with associated bacterial vegetation, consistent with IE. The patient’s condition was further complicated by sepsis and hypochromic microcytic anemia. Management required a high-precision, multi-modal approach to balance competing physiological demands. To eradicate the infection, a synergistic regimen of broad-spectrum antibiotics (Ceftriaxone and Gentamicin) was initiated. Simultaneously, heart failure was addressed using a combination of diuretics (Furosemide, Spironolactone) and afterload reduction via ACE-inhibitors (Captopril). A critical component of the intervention was strict fluid restriction (1900 ml/day) to prevent pulmonary volume overload, despite the concurrent systemic sepsis. Supportive therapies included corticosteroids and gastrointestinal care. This case demonstrates that while sepsis typically necessitates fluid resuscitation, the presence of a PDA-induced shunt requires cautious fluid titration to maintain hemodynamic stability. The successful stabilization of this patient underscores the necessity of aggressive antimicrobial therapy and meticulous fluid management in complex CHD complications. Ultimately, this report emphasizes the vital importance of early PDA closure as a primary preventive measure against the development of high-morbidity Infective Endocarditis.

Perioperative Management of Asthmatic Patient: A Case Report

2026-04-09T10:05:45+00:00

Asthma is a chronic inflammatory disease of the airways, primarily manifested by recurrent episodes of wheezing, shortness of breath, and chest tightness during an acute exacerbation. In the perioperative, asthmatic patients require special consideration, particularly during surgical procedures. Specific anesthetic agents, along with the mechanical irritation of airway instrumentation, potentially trigger acute exacerbations or unexpected bronchospasms that could be fatal. This case report aims to describe the perioperative management and clinical response of an asthmatic patient who experienced unexpected acute exacerbation during anesthesia induction. A 30 year old woman with controlled asthma (ASA II) underwent excision and reconstruction surgery under general anesthesia. Preoperative evaluation included chest X ray and physical examination, both showing normal findings. Sedation was initiated with propofol, fentanyl, ketamine, and atracurium. Clinical manifestations and interventions during surgery were documented. Shortly after induction, the patient developed tachypnea, desaturation (<90%), and diminished breath sounds, indicating acute bronchospasm. Management included aminophylline, dexamethasone, nebulized salbutamol and ipratropium, followed by substitution of atracurium with rocuronium. The patient stabilized, surgery was completed uneventfully, and postoperative recovery was normal. This case highlights that acute asthma exacerbation may occur perioperatively despite long term control, emphasizing the need for vigilant anesthetic assessment, careful drug selection, and readiness to manage bronchospasm promptly.