Jurnal Health Sains

Pedunculated Osteochondroma of the Right Foot Following Traumatic Injury: A Rare Case Report

Muhammad Fariz Al Hakim — 2025-11-29

Osteochondromas are the most common benign bone tumors, accounting for 20-50% of all benign osseous neoplasms. However, osteochondromas involving the foot and ankle are rare, representing only 3-10% of all cases. The relationship between trauma and osteochondroma development remains a subject of clinical interest. A 37-year-old female presented with three-month history of progressive right foot pain following a traumatic fall down stairs. Examination revealed a 5cm × 5cm × 2cm firm, non-mobile mass on the lateral foot with restricted ankle motion. The mass had enlarged from 2cm × 2cm to 4cm × 4cm over three months. Pedunculated osteochondroma was diagnosed clinically and radiologically. Complete surgical excision was performed using osteoclasis technique. Histopathology confirmed benign osteochondroma with uneventful post-operative recovery. The temporal relationship between the traumatic fall and subsequent identification of the osteochondroma raises important questions about whether trauma triggered secondary osteochondroma development or simply brought attention to a pre-existing asymptomatic lesion. Post-traumatic osteochondromas are thought to arise from displacement of growth plate cartilage fragments through the cortex, though the exact mechanism remains incompletely understood. The progressive enlargement over three months in a skeletally mature adult was potentially concerning for malignant transformation; however, the clinical presentation and benign histopathological diagnosis confirmed a benign lesion. Plain radiography demonstrating cortical and medullary continuity with the parent bone remains the primary diagnostic modality, with cross-sectional imaging reserved for cases with atypical features or concern for malignancy. Osteochondroma should be considered in the differential diagnosis of post-traumatic foot masses presenting with hard swelling and restricted motion. Complete surgical excision achieves excellent outcomes with low recurrence rates. Timely diagnosis through appropriate imaging and multidisciplinary collaboration are crucial for optimal management.

What Are the Post-Operative Complication Rates and Quality of Life Improvements Following Tonsillectomy in Children With Chronic Tonsillitis? : a Systematic Review

Fierda Ovita Azhari — 2025-11-29

Chronic tonsillitis is a significant health issue in children, characterized by recurrent throat infections that diminish their quality of life. Tonsillectomy is a common surgical solution, but a comprehensive analysis balancing its benefits against post-operative risks is needed. The purpose of this study was to evaluates post-operative complication rates and quality of life improvements following tonsillectomy in children with chronic tonsillitis. This review followed PRISMA 2020 guidelines. A systematic search was conducted across PubMed, Semantic Scholar, Springer, Google Scholar, and Wiley Online Library for studies published in the last decade. Eleven studies were included. The findings consistently showed significant improvements in quality of life post-tonsillectomy, as measured by validated instruments like the Pediatric Throat Disorders Outcome Test (T-14) and the Pediatric Quality of Life Inventory (PedsQL-P). Post-operative complication reporting was heterogeneous. The most frequently quantified complication was post-tonsillectomy hemorrhage, with rates varying from 2.7% to 7.9% depending on the surgical technique. Other reported complications included pain, halitosis, and uvula edema. Long-term follow-up (5 years) in two studies showed sustained quality of life benefits.

A Case of Anencephaly with Concomitant Maternal Overweight: Clinical Presentation and Outcome

Kanesti Ismirajna G.T — 2025-11-28

Anencephaly, a lethal neural tube defect (NTD), results from failed cranial neural tube closure during early embryogenesis. Maternal risk factors, including obesity and inadequate periconceptional folic acid intake, are well-established contributors. This report describes a case involving a 29-year-old primigravida with a Body Mass Index (BMI) of 28.03 kg/m² (overweight) who was referred at 39 weeks gestation for delivery following a prenatal diagnosis of anencephaly. The patient had no personal history of chronic illness but had not taken folic acid supplements prior to conception, initiating prenatal vitamins only after pregnancy confirmation. A cesarean section delivered a male infant with classic features of anencephaly. Despite resuscitation, the newborn died shortly after birth. The development of anencephaly in this instance is associated with two key modifiable risk factors: maternal overweight status and the absence of preconceptional folic acid supplementation. Neural tube closure occurs within the first month of pregnancy, often before pregnancy recognition, making folic acid initiation after confirmation too late to prevent NTDs. Maternal overweight or obesity is an independent risk factor that can compromise the fetal environment and potentially alter folate metabolism. This case underscores the critical importance of preconception health counseling, emphasizing the necessity of folic acid supplementation for all women of reproductive age, commencing before conception. This public health measure is particularly crucial for women with elevated BMI.

The Effect of Internet Gaming Disorder on Learning Motivation of Students at Sman 21 Medan

Andi Anisa — 2025-11-15

Online gaming behavior can increase excitement and reduce stress in students. However, uncontrolled online gaming behavior will lead to addiction which is then called Internet Gaming Disorder. Students with Internet Gamig Disorder tend to spend their time playing online games rather than their daily activities and this will have an impact on students' tasks as students by neglecting the levers so that they will lose their motivation to learn. This study aims to analyze the influence of Internet Gaming Disorder on the learning motivation of high school students. The design of this research is case control. The sample used in this study was 1:2 ratio, namely 27 students as case subjects and 54 students as control subjects. Data collection was carried out using IDGS-SF9 and AMS questionnaires. The results of this research data were analyzed using the Chi Square test. The results of the study found that the learning motivation of the case subjects was in the average category, namely 26 students (96.3%). Meanwhile, the control subjects of student learning motivation were relatively high, namely 34 students (63%). Based on the results of the Chi Square test, the influence of Internet Gaming Disorde on learning motivation (p<0.05) with an odd ratio of 44.2. Suggestions for further researchers could examine the influence of Internet Gaming Disorder on learning motivation in high school students with a larger population.

Blood Pressure Management in Acute Ischemic Stroke

Ni Made Wini Jayesthiwi Wanami Putri — 2025-11-25

Stroke is a leading cause of death worldwide, with acute ischemic stroke (AIS) being one of its most common forms. AIS occurs when the blood supply to the brain is blocked due to thrombosis or embolism, leading to ischemic brain tissue. Blood pressure management in AIS patients is crucial, as it directly impacts patient outcomes, such as preventing further brain damage, recurrent stroke, and other cerebrovascular complications. The 2019 AHA/ASA guidelines provide distinct strategies for blood pressure management, depending on whether the patient is undergoing reperfusion therapy. For patients with AIS without reperfusion therapy, blood pressure should not be aggressively lowered unless it exceeds 220/120 mmHg. In contrast, for patients undergoing reperfusion therapy, such as IV-tPA or endovascular therapy, blood pressure should be maintained below 185/110 mmHg before and during the procedure. Different antihypertensive agents are used, with short-acting drugs such as labetalol, nicardipine, and hydralazine being commonly employed. Managing blood pressure correctly during AIS treatment is critical in preventing complications such as hemorrhagic transformation and ensuring better long-term neurological outcomes.

Managing Cecal Enterocutaneous Fistula Through Application of Cecostomy Tube : an Effective Approach

Abdul Muthalib Pattiiha — 2025-11-29

One of the rare post appendectomy complications is enterocutaneous fistula in the cecum. There is limited research on surgical treatment for this condition; however, excising the fistula and performing primary closure with placement of a cecostomy tube could be considered as another potential approach. A 12-year-old boy who underwent appendectomy surgery 2.5 years ago presented with a complaint of fecal discharge from a surgical scar in the right lower abdomen, which began 7 days after the operation. He observed intestinal mucosa protruding from the enterocutaneous fistula opening two weeks prior to hospital admission. Fistulography revealed an enterocutaneous fistula in the right lower abdomen originating from the proximal ascending colon. During exploratory laparotomy, an enterocutaneous fistula was identified in the cecum, originating from the appendiceal stump. The fistula was excised, followed by primary suture and insertion of a cecostomy tube, positioned with its end 15 cm proximal to the ileocecal junction. The cecum was then fixed to the right lower abdominal peritoneal wall. The cecostomy tube was removed on the 14th day after surgery, and during follow-up, there were no signs of leakage or recurrence of the fistula. The management of fistulas involves both conservative and surgical approaches. In our instance, surgical intervention included excising the fistula and performing primary suture, along with inserting a cecostomy tube. This approach aimed to preserve the function of the cecum, thereby reducing pressure on it and facilitating decompression. This case is uncommon, and there is limited literature on its treatment. It necessitates personalized management. The use of a cecostomy tube could be considered as an alternative surgical approach in managing enterocutaneous fistulas involving the cecum.

Manual Aid in the Vaginal Delivery of Spontaneous Twin Cephalic-Complete Breech Pregnancy: A Case Report

Gustie Nanda R.P — 2025-12-05

Multiple gestation, particularly those involving a combination of breech and cephalic presentations, presents a complex obstetric challenge. This case report describes the successful vaginal delivery of a twin pregnancy with mixed presentation at 36/37 weeks of gestation. A 28-year-old woman, G2P1A0, presented in active labor with a cervical dilation of 4 cm. The first twin was in cephalic presentation, while the second was in breech. Following the NICE guidelines for twin delivery with a cephalic-presenting first twin, a vaginal delivery was planned. The first baby was delivered spontaneously. For the second, breech-presenting twin, an amniotomy was performed, followed by a Manual Aid for Breech Delivery, resulting in a safe vaginal birth. Both infants had satisfactory Apgar scores, and the third stage was managed without significant postpartum haemorrhage. This case demonstrates that with careful monitoring and skilled intervention, vaginal delivery is a viable and safe option for twin pregnancies with a cephalic-breech combination, potentially avoiding the need for cesarean section. The successful outcome underscores the importance of preparedness for breech extraction and holistic management during the intrapartum and postpartum periods.