Cranial Surgeries in a New Neurosurgery Centre in an Urban Specialist Hospital in Southeast Nigeria: A 40-Month Review

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Background: The Imo State Specialist Hospital (IMSSH) commenced neurosurgical services in April 2021 with outpatient consultations, and a cranial surgery performed in the same month was her first neurosurgical procedure. This is an audit of cranial pathologies surgically managed in the hospital in her first 3 years since the commencement of neurosurgical procedures.

Aims: The study aimed to look at the pattern of cranial pathologies surgically managed in the hospital from the commencement of neurosurgery services, including their age and gender distribution, the cranial pathologies and their distribution.

Methods: The surgical records of all neurosurgery patients who had cranial surgical operations at IMSSH, Owerri, from April 2021 to July 2024 (40 months) were retrospectively reviewed.

Results: One hundred and ninety-two (192) patients had cranial surgical operations during the study period (an average of 5 surgeries per month). The mean age of patients was 39 years with a male-to-female ratio of 1.5:1. The mean age for male patients was 43 years while that of female patients was 32 years. The peak age range at presentation was in the paediatric age group, 0 – 19 years (n=69, 36%), followed by the elderly age group, 60 – 79 years (n=55, 28.6%). The highest frequency of cranial surgeries was performed for hydrocephalus (n=85, 44.3%). This was followed by cranial haematomas (n=52, 27.1%), cranial tumours (n=33, 17.2%) and cranial infections (n=13, 6.8%). Among cases of hydrocephalus, hydrocephalus in children (n=46) accounted for the highest number of cranial surgeries, while among cranial haematomas and cranial tumours, chronic subdural haematoma (n=27, 59.1%) and meningiomas (n=13, 39.3%) accounted for the highest frequencies respectively.

Conclusion: The study showed a male preponderance for cranial pathologies surgically managed in the hospital, with hydrocephalus in children and chronic subdural haematoma in the elderly having the highest presentation in our environment. A focus on preventive measures against hydrocephalus and chronic subdural haematoma may help in reducing the burden of these diseases in our environment.

The COSO ERM Implementation Perspective Analysis on Manufacturing Company: Case Study PT Alcomex Indo

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Internal control implementation of PT Alcomex Indo, a manufacturing company focused on aluminum extrusion based on COSO ERM perspective. This research conclude that the internal control of objective settings in the expenditure cycle is not fully implemented and stated that there is no budgeting system which resulted in the lack of performance evaluation in the expenditure cycle.

Development Strategy of Punti Kayu Tourism Forest in Palembang City, Indonesia; Willingness to Pay (WTP) Base Recommendation

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Punti Kayu is one of the natural tourism forests in Palembang City. Punti Kayu natural tourism forest is a conservation area with a development concept based on protecting the diversity of plant and animal species. Willingness to pay is one of the things that must be considered by tourism managers because the ticket price offered is unknown about the willingness to pay of tourists, there the researcher is interested in conducting this study to find out how satisfied visitors who visit Punti Kayu Nature Tourism and how willing tourists are to pay the ticket price if using the travel cost method. This study aims to (1) determine the level of satisfaction consisting of ticket prices, attractiveness, facilities and experience of visiting Punti Kayu and determine the comparison of satisfaction levels based on the area of origin, (2) determine the value of willingness to pay based on travel costs and determine the relationship between value. willingness to pay with the satisfaction level of visiting Punti Kayu, (3) knowing the formulation of Punti Kayu development strategy in Palembang City.The data processing method used was the calculation of the satisfaction level score, the willingness to pay analysis using the travel cost method and the development strategy analysis using the SWOT analysis. The satisfaction level of tourist visits who became respondents was 60 people and an average score of 3.51 with the satisfied category was 53.30 percent. The result of the analysis of willingness to pay the visit of Punti Kayu respondent based on the travel cost method is Rp30,196.36. Based on the results of the spearman correlation calculation, the sig. (2-tailed) is 0.01 < 0.05, so there is the relationship between willingness to pay and the level of satisfaction. The results of the analysis of Punti Kayu’s development strategy are in quadrant I formulation, namely the SO strategy with the strategy being to make several sports areas such as jogging track and make interseting photo spot such as adding a flower garden with an aesthetic impression.

The Influence of Lipase Enzyme Level and Ca(OH)2 Usage in the Production of Protected Lemuru Fish Oil Supplement on the Texture, Nutrient Content, and Fatty Acid Value of the Product

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The scarcity of  feed energy source to ruminant can be anticipated by adding oil to the feed. However, the effect of adding oil to the feed more than 7% will reduce the activity of fiber-degrading microbes because fat is toxic. In addition, fat in the feed will easily undergo biohydrogenation by rumen microbes so that it will reduce its function. Making fat protection feed using lemuru fish oil with a combination of lipase enzymes and Ca(OH)2 can be a solution because it aims to protect fat from biohydrogenation in the rumen. The experiment used a completely randomized design method with a 3×2 factorial pattern with factors 1) lipase enzyme (0%, 0.5%, and 1%) and factor 2) Ca(OH)2 (20% and 25%). The product results obtained showed that the product quality was in good condition with the product hardness criteria at number 4 (hard). Analysis of variance showed no significant effect on interaction,enzyme factor and Ca(OH)2 factor (P>0.05) on DM, OM, CF and acid number where the combination of L1K20 treatment (1% enzyme and 20% Ca(OH)2) produced the highest DM content of 90.25±1.12%; OM 81.98±1.35%; CF 14.62±0.53%; and the lowest acid number of 0.54±.0.06 mg KOH/g sample. The conclusion that can be given is that the use of a combination of 1% lipase enzyme and 20% Ca(OH)2 in fat protection products produces good quality products in terms of product hardness, high nutrient content and low acid number according to the standard fatty acid number below 1 mg KOH/g sample.

Improving the Management Development Program to Enhance Graduation Rates, Retention, and Effectiveness (Case Study: MDP Mortgage, Maybank Indonesia)

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A robust leadership pipeline is essential for sustained success in the dynamic Indonesian banking sector. Maybank Indonesia’s Management Development Program for Mortgage, designed to cultivate future leaders in this critical business area, faces significant challenges. With a graduation rate of just 51.69% and high attrition, the program falls short of its 80% target, impacting the bank’s ability to develop internal talent and meet strategic objectives. This study employs the DMAIC methodology to diagnose the root causes of this underperformance and propose data-driven solutions. Utilizing tools such as process mapping, surveys, and statistical analysis, the research reveals key weaknesses within the program.

Analysis indicates that inconsistent mentorship practices, characterized by a lack of standardized guidance and individualized support, account for 40% of participant dissatisfaction. Furthermore, a misalignment between the training curriculum and the actual demands of on-the-job tasks contributes to 60% of performance challenges, leading to frustration and decreased participant engagement. To address these critical issues, this study recommends a three-pronged approach: 1) revising the curriculum to reflect on-the-job requirements better, incorporating real-world case studies and simulations; 2) standardizing mentorship processes, providing clear guidelines and training for mentors to ensure consistent support and guidance; and 3) implementing real-time feedback mechanisms, enabling participants to receive timely and constructive feedback on their performance. These targeted improvements are projected to increase graduation rates by 15%, reduce attrition by 10%, and significantly enhance the overall effectiveness of the MDP Mortgage program, ultimately strengthening Maybank Indonesia’s leadership pipeline and contributing to its long-term success in the competitive financial landscape.

Effects of learning culture on English language learning by EFL students at HCMC College of Economics

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The concept of culture encompasses the way people live, including their customs, attitudes, lifestyles, traditions, beliefs, norms, and values within their society (Brown, 2007). Members of a group are aware of the rules of proper and impolite behavior and understand how to use language in various social situations based on a shared set of values, beliefs, and norms. Consequently, languages are used differently depending on the culture. This study aimed to explore the perspectives of Vietnamese students studying English as a Foreign Language (EFL) at HCMC College of Economics on how integrating cultural learning into their English language education influences their learning experience. The research seeks to provide valuable insights into the role of cultural integration in English language education for Vietnamese students. To achieve this, the paper employed quantitative research methods to assess students’ perceptions regarding the importance of incorporating cultural aspects of the English language into their learning process. Additionally, the study examined how the integration of cultural learning impacts the English language proficiency of EFL students. Furthermore, to analyze and interpret the results, the paper recommends employing a qualitative approach, utilizing concepts or findings from previous research to support the data. Based on a population size of 168 students who are third-year English major at Ho Chi Minh City College of Economics, Ho Chi Minh City. The analysis results indicate that students positively value the importance of culture learning in English learning. Also, there is a strong correlation between students’ perceptions for cultural learning, their cultural knowledge, and their English learning progress.

Proposed Business Strategy to Increase Competitiveness for Chemical Textile Company: A Case Study of CV XYZ

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CV XYZ, a chemical textile company, has faced fluctuating profitability, requiring a robust business strategy to improve financial performance and market position. This research identifies the root causes of these challenges and proposes actionable solutions through a comprehensive analysis of both external and internal factors. External evaluations, including market and competitor assessments, are combined with internal analyses such as resource and value chain analysis, core competencies, and the VRIO framework. These insights are summarized in a SWOT and TOWS matrix, highlighting the company’s strengths and weaknesses. The findings reveal that CV XYZ is competitive due to its ability to offer customized products that meet customer needs and provide affordable solutions. Its innovative alkali-based remover and eco-friendly formulations differentiate it from competitors and provide significant growth potential. However, operational inefficiencies hinder performance, such as inefficient workflows, delayed deliveries, and multitasking sales teams. Overlapping roles and the need for further product refinement also present challenges. This study recommends integrating cost leadership and differentiation strategies streamlining operations to reduce costs while maintaining product quality and innovation. This dual strategy will help CV XYZ meet the needs of both price-sensitive and sustainability-conscious customers, improving profitability and ensuring long-term success.

The Effect of Spraying Calcium Nano Fertilizer and Humic Acid on the Growth and Yield of Cauliflower Crop in Calcareous Soils

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This research aims to demonstrate the effect of using nano-fertilizer (calcium oxide) on the growth of cauliflower at concentrations (0, 100, 200) ppm and humic acid in concentrations (0, 2, 4) ml .l-1 and its effect in growth and yield of cauliflower crop (plant height, disc weight, and total yield) also (diameter of disc, leaf area, fresh leaf weight) and study this effects in calcareous conditions in calcareous soil. The results showed the superiority of the treatment (H2+Ca200) in terms of its impact togather on the studied treatments, as it achieved the best results, which reached 47.18 cm, 0.97 kg, 40.95 T.ha-1, 24.60 cm, 284.33cm2, 0.99 kg  respectively,  There were significant differences between the studied treatments, and the experiment showed the possibility of using a combination of foliar fertilization of both organic humic acid and nano-calcium fertilizer in achieving the best growth and production rates for cauliflower plant yield.

Measurement of Diabetic Patient’s Kidneys CT Number using Computed Tomography

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The study was conducted in Khartoum state on diabetic patients utilizing Computed Tomography. The aim was to assess CT numbers for both kidneys and analyze their correlation with age. A total of 522 participants were examined (138 from the control group and 384 from the diabetic group). The results indicated that the average age of the case group was 58.5, with the mean measurements for the right and left kidneys of the case group being (Rt K Cortical CT number, Rt K Medulla CT number, Lt K Cortical CT number, Lt K Medulla CT number), with means of (36.53), (25.33), (4.91), (36.5), and (25.19), respectively. There were no statistically significant correlations between kidney measurements and the age of the case group (p-values: .214, .620, .865, .806); Whereas, Rt K Medulla CT number decreased with increasing age. Pv (.028). The diabetes did not influence the cortex and medulla CT number pv (0.852, 0.582, 0.872, 0.615).

Management of a Patient with Type 2 Diabetes Mellitus and Uncontrolled Hypertensive Urgency Using a Family Doctor Approach in a First-Level Health Facility in Indonesia: A Case Report

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Noncommunicable diseases (NCDs) result from genetic, environmental, and behavioral factors. These diseases include cardiovascular conditions and diabetes. According to the Lampung Provincial Health Office in 2021, the prevalence of type 2 diabetes mellitus increased from 1.37% to 3.76% (equivalent to 88,518 cases), and the prevalence of hypertension rose from 15.10% to 17.35%. NCDs are chronic and affect quality of life and productivity, necessitating comprehensive management.  The goal of a family medicine approach in treating patients with type 2 diabetes mellitus and hypertension is to identify clinical, psychological, and psychosocial factors. Primary data is collected through anamnesis, physical examination, and home visits to evaluate the physical environment.  Patient Mrs. A, a 55-year-old farmer, reported complaints of headaches and frequent nighttime urination. She has a history of hypertension since 2022 and type 2 diabetes mellitus since 2023. Management was carried out holistically using a patient-centered, family-oriented, and community-based approach grounded in Evidence-Based Medicine. Interventions included both pharmacological and non-pharmacological via family conferences.  Evaluation of the interventions showed improved knowledge among the patient and her family, a reduction in the patient’s blood pressure and blood glucose levels, and behavioral changes in the patient to consume meals aligned with recommended dietary allowances.