A Case of Solitary Fibrous Tumor Presenting as Lower Neck Mass

Solitary fibrous tumor (SFT) is rare mesenchymal tumor usually arising from pleura. SFT can be found at all anatomic site in our body but incidence of SFT is much lower in head and neck region especially at lower neck area. We found a case of SFT that presented as a lower neck mass in a 41-year old woman. Ultrasonography showed a 3×1cm sized hypoechoic mass in the intermuscular fat plane of left lower neck, and computed tomography showed a well circumscribed, low-density mass with contrast enhancement. Fine needle aspiration showed no malignant cells with abundant red blood cells, but it was not possible to completely rule out malignant tumors or nodules clinically. Surgery was performed to make a definitive diagnosis and histopathology showed tightly packed, round to fusiform cells with staghorn shaped vessels at microscopic examination. The tumor cell were positive for CD34 but negative for CD31 and S-100 protein.

Designing of Facility Layout Ecobrick Material Using Ergonomic Intervention Reduce Muscoloskeletal Disorder

Kamulyan waste bank is a place to collect the waste from the household around Lowanu Village, Brontokusuman, Mergangsan, Yogyakarta. This waste is distributed to garbage collectors and sorted. Plastic waste that cannot be recycled is used as material for making ecobricks. Ecobricks are materials made from used plastic bottles filled with plastic sachets, plastic bags, and similar materials that are compressed. In making ecobricks, workers perform activities in a sitting position on the floor with both legs folded in and a slightly bent posture. This work attitude causes muscle complaints in the upper and lower neck, upper arm, right elbow, left wrist, and left hand. The purpose of the study was to improve work attitudes to reduce muscle complaints in body parts by designing ergonomic work facilities. This research was conducted with ergonomics intervention on the design of ecobrick plastic compaction work facilities with the Nordic Body Map-VAS Modified Questionnaire. The muscle complaints of the workers' body parts were determined using the Nordic Body Map questionnaire. The results of the study provide a design for compaction of ecobrick plastic materials with dimensions of table length 134.44 cm, table width 66.39 cm, table height 71.63 cm, length of seat mat 41.41 cm, width of seat mat 43.49 cm, height seat 44.51 cm, backrest height 55.5 cm, and backrest width 45.88 cm. Based on the NBM-VAS questionnaire, it shows that the initial condition of pain or pain in the upper neck and lower neck with a moderate pain value is aimed at a scale of 6.5 cm and 7.3 cm to mild pain with a scale of 4.2 cm and 4.3 cm. . Moderate pain in the left wrist and left hand with a scale of 6.1 cm, respectively, to no pain on a scale of 3.1 cm and 3 cm.

RISK OF MUSCULOSCELETAL DISORDERS (MSDS) ON TRADITIONAL JEWELRY CREAMERS

The risk of Musculoskeletal Disorders (MSDs) can occur in a variety of occupations including in traditional jewelers. The complaint is caused by an awkward position during work activities. The study aims to identify complaints of Musculoskeletal Disorders (MSDs). This study used qualitative approach through in-depth interviews on 5 key informants and 2 key expert informants and ergonomic risk determination referring to the BRIEF method. The results showed that all informants experienced complaints of the upper neck, lower neck, right shoulder, back, right elbow, right upper arm, and right forearm. Measurements through the BRIEF sheet show that complaints on the left and right elbows, left and right shoulders, neck, and back include high category ergonomic hazards while complaints on the hands and wrists of the right include moderate category ergonomic hazards. High risk of Musculoskeletal Disorders (MSDs) is found at all stages of work (smelting, grinding, posturing, jewelry formation, and gilding). Therefore, workers are recommended to perform muscle relaxation for (8-12 seconds) every half hour.

Viscera of the neck

The thyroid gland is a symmetrical H-shaped endocrine structure in the lower neck. It consists of two lobes, each extending from the oblique line of the thyroid cartilage above to the sixth tracheal ring below – united by a median isthmus covered by the anterior jugular veins. The small, (usually) paired and inconsistent parathyroid glands lie behind the lobes of the thyroid gland. They measure 6mm by 4mm by 2mm and are ordinarily four in number – two superior and two inferior. They are involved in the careful regulation of the body’s calcium levels. Both superior and inferior glands are ordinarily supplied by the inferior thyroid artery. Drainage is into the venous plexus on the anterior surface of the thyroid.

Kelelahan Mata dan Keluhan MSDs Perkuliahan Daring Selama Pandemi COVID-19 pada Mahasiswa di Tiga Fakultas Universitas Sari Mulia (Program Studi Teknik Industri, D-IV Promosi Kesehatan dan Program Studi Manajemen)

The spread of COVID-19 cases is very fast, affecting all sectors. One of these sectors is educational institutions. In order for the learning process to continue, an online learning system was implemented. Online learning causes an increase in sitting rather than standing, activity in front of a smartphone or laptop. The purpose of this study is to identify eye fatigue and MSDs complaints in students at three study programs, Industrial Engineering, DIV-Health Promotion and Management. The data was collected through an online survey of students. This study used a descriptive analysis research design with a cross sectional approach with the number of respondents 55 students. The results showed that eye fatigue was mostly experienced with sore eyes as many as 35 students (63.63%). Then followed by headaches as many as 34 people (61.81%) and watery eyes as many as 23 people (41.81%). Meanwhile, the majority of MSDs complaints among students were at the waist as many as 34 people (61.8%), on the upper neck as many as 33 people (60%) and on the lower neck as many as 25 people (45.5%). Penyebaran yang kasus COVID-19 yang sangat cepat, berdampak terhadap semua sektor. Salah satu sektor tersebut adalah institusi pendidikan. Agar proses pembelajaran tetap berjalan, maka dilaksanakan sistem pembelajaran daring. Pembelajaran daring menyebabkan terjadinya peningkatan aktivitas duduk daripada berdiri, aktivitas di depan smartphone atau laptop. Selain itu, pembelajaran daring dapat meningkatkan kelelahan mata karena aktivitas di depan smartphone atau laptop. Tujuan dari penelitian ini yaitu mengidentifikasi kelelahan mata dan keluhan MSDs pada mahasiswa di tiga program studi yaitu Program Studi Teknik Industri, Program Studi DIV-Promosi Kesehatan dan Program Studi Manajemen. Pengumpulan data dilakukan melalui survei secara daring terhadap mahasiswa. Penelitian ini menggunakan desain penelitian analisis deskriptif dengan pendekatan cross sectional dengan jumlah responden 55 orang mahasiswa. Hasil penelitian didapatkan keluhan kelelahan mata yang paling banyak dialami oleh responden adalah mata perih sebanyak 35 orang mahasiswa (63,63%). Kemudian diikuti keluhan sakit kepala sebanyak 34 orang (61,81%) dan mata berair sebanyak 23 orang (41,81%). Sedangkan untuk keluhan MSDs pada mahasiswa adalah mayoritas pada bagian pinggang sebanyak 34 orang (61,8%), pada bagian leher atas sebanyak 33 orang ( 60%) dan pada bagian leher bawah sebanyak 25 orang (45,5%).

Multiple site neural tube defects at Zewuditu Memorial Hospital, Addis Ababa, Ethiopia: a case report

Background Neural tube defects are common group of central nervous system anomalies of complex etiology and major public health importance worldwide. The occurrence of multiple neural tube defects, however, is an extremely rare event and has never been reported in Ethiopia so far. This study gives an insight into how the embryogenesis, management, and postoperative complications of multiple neural tube defects differ from the ordinary single neural tube defects on the basis of up-to-date existing literature. Case presentation This paper highlights a case of an 8 days old female black race Ethiopian neonate who was brought by her mother with the chief complaint of lower back and lower neck swelling since birth. The findings were a 5 × 4 × 5 cm sized ulcerated placode at the mid-lumbosacral area and a 1.5 × 1.5 × 1 cm sized fluctuant, nontender, transilluminating mass with overlying unruptured defect dysplastic skin at the cervicothoracic junction. With a diagnosis of multiple neural tube defects secondary to unruptured cervicothoracic meningocele and ruptured lumbosacral myelomeningocele, single-stage repair of the defects was done with good outcome. Conclusion There is insufficient evidence as to the exact mechanism of development of multiple neural tube defects. Similarly, whether patients with multiple neural tube defects had increased risk of post repair hydrocephalus compared with patients who have single neural tube defect is unknown. Hence, more research on the embryogenesis, management, and long-term outcome of multiple neural tube defects in particular and single neural tube defects in general should be done to better help patients with this costly and crippling problem. Lastly, the practice of folic acid supplementation is very low in resource-limited countries such as Ethiopia and, hence, should be improved.

Forgotten disease: an atypical case of Lemierre syndrome presenting as a soft tissue abscess

Lemierre syndrome (LS) is an acute oropharyngeal infection with secondary septic thrombophlebitis and distant septic embolisation. A 29-year-old woman with sore throat, dyspnoea and left shoulder pain, who was on levofloxacin for 3 days, presented with worsening symptoms. She was tachycardic, tachypneic and hypoxic on presentation. CT of neck and chest revealed multiple loculated abscesses on her left lower neck and shoulder, right peritonsillar abscess, thrombosis of the right external jugular vein and multiple bilateral septic emboli to the lungs. She was started on clindamycin and ampicillin sulbactam for LS. She developed septic shock and required intubation due to respiratory failure. Drainage of the left shoulder abscess grew Fusobacterium nucleatum. After 2 weeks of a complicated intensive care unit stay, her haemodynamic status improved and she was transferred to the floor. LS has variable presentations, but regardless of the presentation, it is a potentially fatal disease-requiring prompt diagnosis and management.

DIAGNOSTICS OF NERVE IMPULSES TRANSMISSION PATHOLOGY IN PATIENTS WITH SUSPECTED THORACIC OUTLET SYNDROME USING CLINICAL NEUROPHYSIOLOGY TESTS

Introduction Thoracic Outlet Syndrome (TOS) is a group of conditions characterized by compression of the nerves, arteries and veins in the lower neck and upper chest area. On average, six physicians of different specialities need 4.3 years to develop TOS diagnosis. Early detection of changes in transmission of nerve impulses within the brachial plexus may lead to faster and more effective treatment of patients. Aim The aim of the study is to present the scheme of diagnostic tests of clinical neurophysiology contributing to the objective diagnosis of TOS, as well as the positive results of tests in a group of sixteen patients with clinically confirmed pathological symptoms. Material and methods Sixteen patients with clinically diagnosed TOS and sixteen healthy people as a control group aged from 18 to 36 participated in this study. In both groups of subjects, bilateral clinical neurophysiological diagnostics tests were carried out: an examination of the sensory perception with von Frey’s filaments within C4-C8 dermatomes, examination of surface electromyography (sEMG) during maximal contractions when recordings from proximal and distal muscles of the upper extremities were performed, the electroneurographic transmission of nerve impulses in selected nerves of the upper extremities (ENG) and motor evoked potentials recordings induced with the magnetic field (MEP) following oververtebral C5 and C6 stimulation. Results Comparing to studies performed in a control group of healthy volunteers, more than 50% of patients with clinical symptoms of TOS had confirmed abnormalities in the diagnostic tests of clinical neurophysiology, unilaterally or bilaterally. Conclusions In the diagnosis of TOS, sEMG recordings from the distal muscles of upper extremities during maximal contractions after induction of ischemia (“hand-raised test”), ENG segmental examination of nerve impulses transmission in motor fibers after stimulation of the median and ulnar nerves, and MEP examination after oververtebral C5 and C6 stimulation are particularly useful. Confirmation of a relatively high percentage of positive TOS tests in patients requires a greater number of neurophysiological examinations. Keywords: Thoracic Outlet Syndrome, neurophysiological diagnostics, motor evoked potentials

The relation between neck strength and psychological distress: preliminary evidence from collegiate soccer athletes

Aim: To examine whether neck strength and symmetry are associated with psychological function in athletes with exposure to repetitive head impacts. Methods: Collegiate soccer (n = 29) and limited/noncontact (n = 63) athletes without a history of concussion completed the Brief Symptom Inventory 18 and assessments of isometric neck strength. Neck strength symmetry was calculated as the difference in strength between opposing muscle groups. Results: The results demonstrated that lower neck strength was associated with more symptoms of anxiety, whereas asymmetry in neck strength was associated with more symptoms of somatization and depression in soccer athletes only. Conclusion: These preliminary results suggest that greater neck strength/symmetry is related to better psychological function in athletes who have higher exposure to repetitive head impacts.

Comparison of standard automotive industry injury predictors and actual injury sustained during significant whiplash events

Purpose We present a unique opportunity to compare standard neck injury criteria (used by the automotive industry to predict injury) with real-life injuries. The injuries sustained during, and the overall kinematics of, a television demonstration of whiplash mechanics were used to inform and validate a vertebral level model of neck mechanics to examine the relevance of current injury criteria used by the automotive industry. Methods Frontal and rear impact pulses, obtained from videos of sled motion, were used to drive a MADYMO human model to generate detailed segmental level biomechanics. The maximum amplitude of the frontal and rear crash pulses was 166 ms−2 and 196 ms−2, respectively, both with a duration of 0.137 s. The MADYMO model was used to predict standard automotive neck injury criteria as well as detailed mechanics of each cervical segment. Results Whilst the subject suffered significant upper neck injuries, these were not predicted by conventional upper neck injury criteria (Nij and Nkm). However, the model did predict anterior accelerations of C1 and C2 of 40 g, which is 5 times higher than the threshold of the acceleration for alar ligament injury. Similarly, excessive anterior shear displacement (15 mm) of the skull relative to C2 was predicted. Predictions of NIC, an injury criterion relevant to the lower neck, as well as maximum flexion angles for the lower cervical segments (C3–T1) exceeded injury thresholds. Conclusion The criteria used by the automotive industry as standard surrogates for upper neck injury (Nij and Nkm) did not predict the significant cranio-cervical junction injury observed clinically.