Bioscientia Medicina : Journal of Biomedicine and Translational Research

Serum High Mobility Group Box 1 (HMGB1) Protein Levels and Cognitive Function in Epilepsy Patients: A Cross-Sectional Study

2024-11-24T16:48:05+00:00

Background: Epilepsy is a neurological disease with a high incidence rate. Cognitive decline is one of the consequences of recurrent seizures. Neuroinflammation is closely related to the development of epilepsy and cognitive impairment. An increase in the expression and translocation of High Mobility Group Box 1 (HMGB1) from the nucleus to the extracellular space has been observed in epilepsy patients and experimental animal models. This study aimed to investigate the relationship between serum HMGB1 levels and cognitive function in epilepsy patients.

Methods: This cross-sectional observational study involved 45 epilepsy patients. Cognitive function was assessed using the Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina), and serum HMGB1 levels were measured using the ELISA technique. The relationship between cognitive function and HMGB1 levels was analyzed using the Kruskal-Wallis test, with a significance level set at p < 0.05.

Results: The mean age of the participants was 28.5 years, with a higher proportion of females. The mean serum HMGB1 level was 22.6 ng/ml. No significant relationship was found between serum HMGB1 levels and cognitive function in epilepsy patients (p = 0.188).

Conclusion: Serum HMGB1 protein levels were not associated with cognitive function in this sample of epilepsy patients.

The Inhibitory Potential of Strawberry (Fragaria x ananassa) Extract Against Staphylococcus aureus: Implications for Dental Caries Prevention

2024-11-27T16:48:23+00:00

Background: Dental caries is a prevalent oral health issue globally, and Staphylococcus aureus is a key pathogen involved in its development. Strawberry fruits, known for their medicinal properties, contain bioactive compounds with potential antibacterial effects. This study aimed to investigate the inhibitory potential of strawberry extract against S. aureus.

Methods: A laboratory experimental study was conducted using a post-test-only control group design. Varying concentrations (10%, 15%, 20%, 25%) of strawberry fruit extract were prepared. The antibacterial activity was assessed using the disc diffusion method against S. aureus. Distilled water served as a negative control. The diameter of inhibition zones was measured after 24 hours of incubation at 37°C.

Results: Strawberry fruit extract demonstrated inhibitory effects on the growth of S. aureus at concentrations of 15%, 20%, and 25%. The average inhibition zone diameters were 0.54 mm, 2.30 mm, and 3.00 mm, respectively. No inhibition was observed at 10% concentration or with the distilled water control.

Conclusion: Strawberry fruit extract exhibits potential as an antibacterial agent against S. aureus, suggesting its possible application in dental caries prevention. Further research is needed to explore its clinical efficacy and identify the specific bioactive compounds responsible for the observed antibacterial activity.

Quantifying the Pulmonary Risks of Volcanic Gas Inhalation: A Meta-Analysis

2024-12-01T16:49:07+00:00

Background: Volcanic eruptions release a complex mixture of gases and particulate matter, posing significant respiratory health risks. This meta-analysis aims to quantify the association between volcanic gas inhalation and adverse pulmonary effects.

Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for studies published between 2013 and 2024 investigating the respiratory effects of volcanic gas exposure. Studies reporting quantitative data on lung function, respiratory symptoms, or disease prevalence were included. Random-effect models were used to pool effect estimates, and heterogeneity was assessed using the I² statistic.

Results: Six studies (n = 2,215 participants) met the inclusion criteria. Volcanic gas exposure was associated with a significant decrease in FEV1 (forced expiratory volume in 1 second) (standardized mean difference [SMD] = -0.55, 95% CI: -0.67 to -0.42, I² = 51%), increased prevalence of asthma (odds ratio [OR] = 3.31, 95% CI: 1.84 to 5.96, I² = 76%), and chronic bronchitis (OR = 2.86, 95% CI: 1.97 to 4.15, I² =0%). Subgroup analysis revealed a stronger association between gas exposure and respiratory effects in children and individuals with pre-existing lung conditions.

Conclusion: This meta-analysis provides compelling evidence that volcanic gas inhalation is detrimental to respiratory health. Public health interventions should prioritize vulnerable populations during and after volcanic eruptions.

Mechanical Injury Predominates in Rural Bali, Indonesia: Implications for Prevention and Treatment of Ocular Trauma

2024-12-03T16:49:51+00:00

Background: Ocular trauma constitutes a significant global health concern, leading to preventable visual impairment and blindness. This study delves into the clinical characteristics of ocular trauma in Karangasem Regency, Bali, Indonesia, with an emphasis on the prevalence of mechanical injuries and their subsequent implications for preventive measures and treatment strategies.

Methods: A retrospective observational study was conducted using medical records of patients diagnosed with ocular trauma at two hospitals in Karangasem Regency from January to December 2023. Data collected included demographics, type of trauma, cause of injury, onset, treatment, complications, and visual acuity.

Results: The study encompassed 385 patients (392 eyes) with ocular trauma. The majority of patients were male (78.7%), resided in rural areas (77.4%), and were adults aged 19-44 years (46.49%). Mechanical injury was the most prevalent type (45.15%), with closed-globe injuries accounting for 43.62% and open-globe injuries accounting for 1.53%. The leading causes of trauma were foreign bodies (44.13%) and blunt injury (27.04%). Notably, only 52.31% of patients sought medical attention within 24 hours of injury. The most frequent complications included subconjunctival bleeding (20.4%), corneal erosion (15.5%), and palpebral rupture (8.9%).

Conclusion: Mechanical injury is the predominant type of ocular trauma in rural Bali, primarily affecting adult males involved in labor-intensive occupations. The delayed presentation for treatment underscores the need for heightened awareness and improved access to healthcare services. These findings emphasize the importance of targeted prevention programs and prompt management of mechanical eye injuries to reduce the burden of ocular trauma in rural Indonesia.

Early Ischemic Stroke Assessment with ASPECTS: A Case Report Highlighting the Radiologist's Role in a Limited-Resource Setting

2024-12-01T16:48:53+00:00

Background: Ischemic stroke is a leading cause of morbidity and mortality globally, particularly in resource-limited settings. Non-contrast computed tomography (NCCT) is often the primary imaging modality available in these settings, and the Alberta Stroke Program Early CT Score (ASPECTS) is a crucial tool for assessing early ischemic changes in NCCT. This case report highlights the importance of ASPECTS in guiding clinical decisions and prognostication in a resource-limited setting.

Case presentation: A 79-year-old male presented to the emergency unit at Negara General Hospital, a rural facility in Bali, with acute onset of right-sided hemiparesis and speech difficulty. NCCT showed a hypodense lesion with ill-defined margins in the left insular cortex, left caudate nucleus, left internal capsule, and left frontotemporoparietal lobes, consistent with a subacute cerebral infarction in the middle cerebral artery (MCA) territory, with an ASPECTS score of 2. Due to the extensive ischemic burden and the limited availability of advanced treatment options, conservative management was chosen. The radiologist's interpretation of the ASPECTS score played a critical role in guiding the clinical team's decision-making and informing the patient's family about the prognosis.

Conclusion: ASPECTS is an essential tool for predicting stroke outcomes, with lower scores correlating with larger infarct volumes and poorer prognoses. In resource-limited settings, radiologists play a vital role in interpreting ASPECTS scores to guide clinical management and provide accurate prognostic information to patients and their families.

Egg White Extract Supplementation Improves Albumin and IGF-1 Levels in Malnourished Elderly Patients: A Randomized Controlled Trial

2024-12-03T16:49:37+00:00

Background: Malnutrition is a prevalent issue among the elderly, often leading to hypoalbuminemia (low albumin levels) and decreased serum Insulin-like growth factor 1 (IGF-1) levels. These conditions are associated with increased morbidity and mortality. Egg white extract (EWE) supplementation has shown promise in improving hypoalbuminemia. This study investigated the effects of EWE supplementation on serum albumin and IGF-1 levels in malnourished elderly patients.

Methods: A double-blind randomized controlled trial was conducted, involving 46 malnourished elderly inpatients with hypoalbuminemia. Participants were randomly assigned to receive either EWE (30 grams daily) or a placebo for two weeks. Serum albumin and IGF-1 levels were measured before and after the intervention.

Results: After two weeks, the EWE group showed a significant increase in both serum albumin and IGF-1 levels compared to the placebo group. The mean serum albumin level in the EWE group increased from 2.80 g/dL to 3.7 g/dL, while the placebo group remained unchanged. The mean serum IGF-1 level in the EWE group increased from 1.74 ng/mL to 24.74 ng/mL, while the placebo group experienced a smaller increase. There was a moderate positive correlation between changes in albumin and IGF-1 levels.

Conclusion: EWE supplementation effectively improves serum albumin and IGF-1 levels in malnourished elderly patients with hypoalbuminemia. This intervention may help reduce malnutrition-related complications and improve overall health outcomes in this vulnerable population.

A Meta-Analysis Comparing the Effectiveness of Uterine-Sparing Procedures versus Hysterectomy for Adenomyosis: Patient-Reported Outcomes and Fertility Preservation

2024-12-03T16:49:23+00:00

Background: Adenomyosis is a benign gynecological condition that can cause significant morbidity, including dysmenorrhea, menorrhagia, and pelvic pain. Hysterectomy has been the traditional treatment for adenomyosis, but uterine-sparing procedures (USPs) are increasingly being considered, especially for women who desire fertility preservation. This meta-analysis compared the effectiveness of USPs versus hysterectomy for adenomyosis, focusing on patient-reported outcomes (PROs) and fertility preservation.

Methods: A systematic search of PubMed, Embase, and Cochrane Library databases was conducted for studies published between 2013 and 2024, comparing USPs (e.g., laparoscopic or hysteroscopic adenomyomectomy, uterine artery embolization) with hysterectomy for adenomyosis. Studies reporting PROs (dysmenorrhea, menorrhagia, pelvic pain, quality of life) and fertility outcomes (pregnancy rate, live birth rate) were included. Random-effects models were used to pool data and assess heterogeneity.

Results: Six studies (n = 1248 patients) met the inclusion criteria. USPs were associated with significantly lower rates of major complications (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.23-0.54, p<0.0001) and shorter hospital stays (mean difference -2.73 days, 95% CI -3.29 to -2.17, p<0.0001) compared to hysterectomy. PROs, including dysmenorrhea, menorrhagia, and pelvic pain, significantly improved in both groups, with no significant difference between USPs and hysterectomy. Fertility preservation was significantly higher in the USP group (OR 3.9, 95% CI 3.02-5.03, p<0.0001).

Conclusion: USPs offer a safe and effective alternative to hysterectomy for adenomyosis, with comparable improvements in PROs and significantly higher rates of fertility preservation. This information can guide clinicians and patients in shared decision-making regarding the optimal treatment approach.

An Unusual Case of Pemphigus Foliaceus Arising in a Patient with Psoriasis Vulgaris

2024-12-03T16:49:08+00:00

Background: Pemphigus foliaceus (PF) is a rare autoimmune blistering disease characterized by superficial, fragile blisters. Psoriasis vulgaris, a chronic inflammatory skin condition, has been rarely associated with PF. This case report presents an unusual instance of PF developing in a patient with a history of psoriasis vulgaris.

Case presentation: A 54-year-old Indonesian woman presented with a one-year history of scaly skin and reddish spots across her body, worsening over the past week. She had a prior diagnosis of psoriasis vulgaris and was undergoing methotrexate therapy (15 mg/week) without significant improvement. Three months prior, she developed loose blisters on her back that spread to her hands, rupturing easily and leaving painful sores. The patient denied any mucosal involvement. One week before her presentation, her symptoms worsened following relocation-related stress. Dermatological examination revealed generalized multiple erythematous patches with scales, some with ruptured blisters leaving erosions, and a positive Nikolsky sign. Histopathological examination confirmed PF. The patient was treated with intravenous methylprednisolone, oral erythromycin and paracetamol, topical mupirocin, and clobetasol. After one month, due to a lack of improvement, azathioprine was added, leading to lesion improvement without side effects.

Conclusion: This case highlights the rare but potential development of PF in patients with psoriasis vulgaris. The complex interplay between these two conditions warrants further investigation. Early diagnosis and appropriate treatment are crucial for managing PF and improving patient outcomes.

Accuracy of Fat Mass and Muscle Mass Measured by Bioelectrical Impedance Analysis in Predicting Osteoporosis in Older Adults

2024-12-05T16:51:21+00:00

Background: Osteoporosis is a prevalent bone disease characterized by reduced bone mineral density (BMD) and increased fracture risk. This study aimed to evaluate the accuracy of fat mass (FM) and muscle mass measured by bioelectrical impedance analysis (BIA) in predicting osteoporosis in older adults.

Methods: A cross-sectional study was conducted on 109 outpatients aged 60 years and older. FM parameters (total fat mass, visceral fat level, and fat mass index [FMI]) and muscle mass parameters (total muscle mass, appendicular skeletal muscle mass [ASM], and appendicular skeletal muscle mass index [ASMI]) were measured using BIA. Osteoporosis was diagnosed based on BMD measurements using dual-energy X-ray absorptiometry (DXA). Receiver operating characteristic (ROC) curves were used to determine cut-off points and assess the accuracy of BIA parameters in predicting osteoporosis.

Results: The prevalence of osteoporosis was 52.3% (n=57). The optimal cut-off points for predicting osteoporosis were: total fat mass >36.25%, visceral fat level >12.05, FMI >7.82 kg/m², total muscle mass <37.82 kg, ASM <16.795 kg, and ASMI <6.895 kg/m². Among the FM parameters, visceral fat level had the highest accuracy (AUC = 60.9%, sensitivity = 64.9%, specificity = 78.8%) while FMI had the lowest (AUC = 53.5%, sensitivity = 56.1%, specificity = 57.7%). For muscle mass parameters, ASM showed the highest accuracy (AUC = 74.0%, sensitivity = 70.2%, specificity = 76.9%).

Conclusion: BIA-derived FM and muscle mass parameters, particularly visceral fat level and ASM can be used to predict osteoporosis in older adults with good accuracy. This non-invasive and accessible method may be useful as a screening tool for osteoporosis, especially in settings where DXA is unavailable.

Deep Mycosis in Central Java, Indonesia: Occupational Risk Factors and Diagnostic Challenges in a Single Center Dr. Moewardi General Hospital

2024-12-10T16:53:49+00:00

Background: Deep mycosis, a spectrum of invasive fungal infections affecting deeper tissues, poses significant diagnostic and therapeutic challenges, particularly in tropical regions like Central Java, Indonesia. This study aimed to investigate the epidemiological trends, occupational risk factors, and diagnostic challenges associated with deep mycosis in this region.

Methods: A retrospective study was conducted at a single center, Dr. Moewardi General Hospital, in Central Java, Indonesia, analyzing medical records of patients diagnosed with deep mycosis between 2019 and 2024. Data on demographics, occupation, clinical presentation, diagnostic methods, and treatment outcomes were collected and analyzed.

Results: A total of 12 cases of deep mycosis were identified. The majority of patients were male (75%) and engaged in agricultural activities (50%). Chromoblastomycosis (66.7%) and maduromycosis (25%) were the most common clinical diagnoses. Diagnostic delays were frequent (mean delay: 5.1 months), primarily due to non-specific clinical presentations and limited access to diagnostic facilities.

Conclusion: Deep mycosis predominantly affects individuals involved in agriculture in Central Java, highlighting the need for enhanced awareness and preventive strategies among high-risk occupational groups. Improved diagnostic facilities and healthcare infrastructure are crucial for timely diagnosis and effective management of deep mycosis in resource-constrained settings.

Effectiveness of Vitamin D Supplementation in Reducing Atopic Dermatitis Severity in Children: A Meta-Analysis

2024-12-10T16:53:35+00:00

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that commonly affects children, with increasing prevalence worldwide. Vitamin D has demonstrated immunomodulatory effects, suggesting a potential role in AD management. This meta-analysis aimed to evaluate the effectiveness of vitamin D supplementation in reducing AD severity in children.

Methods: A systematic search of PubMed, Science Direct, and Cochrane databases was conducted for randomized controlled trials (RCTs) published between 2012 and 2024, investigating the effects of vitamin D supplementation on AD in children. The primary outcome was the change in SCORAD (SCORing Atopic Dermatitis) or EASI (Eczema Area and Severity Index) scores. Meta-analysis was performed using Review Manager (RevMan 5.4) software.

Results: Four RCTs met the inclusion criteria, comprising a total of 234 participants. The meta-analysis revealed a significant reduction in SCORAD scores (-2.83; 95% CI: -4.9, -0.76) and EASI scores (-0.41; 95% CI: -0.70, -0.13) in the vitamin D supplementation groups compared to the control groups. A combined analysis of both scoring systems further confirmed the overall significant effect of vitamin D in reducing AD severity (-1.57; 95% CI: -2.78, -0.36).

Conclusion: Vitamin D supplementation is effective in improving AD symptoms in children. Further large-scale RCTs are warranted to determine the optimal dosage and duration of vitamin D supplementation for AD management in children.

Challenges in the Management of Hypertrophic Pyloric Stenosis in a Malnourished Infant with Pulmonary Tuberculosis: A Case Report

2024-12-16T16:54:33+00:00

Background: Hypertrophic pyloric stenosis (HPS) is a common cause of gastric outlet obstruction in infants, but its management can be challenging in the presence of comorbidities like malnutrition and pulmonary tuberculosis (PTB). This case report highlights the complexities and considerations in managing an infant with HPS, PTB, and severe malnutrition.

Case presentation: A 6-month-old male infant presented with lethargy, recurrent vomiting, and failure to thrive. He had a history of PTB on anti-tuberculosis treatment and was severely malnourished. Investigations revealed HPS, and he underwent a pyloromyotomy. Postoperatively, he required careful fluid management, nutritional support, and continued anti-tuberculosis therapy.

Conclusion: This case highlights the challenges in managing HPS in an infant with PTB and severe malnutrition. It underscores the importance of a multidisciplinary approach involving pediatricians, surgeons, and nutritionists to ensure optimal outcomes in such complex cases.

Prevalence and Risk Factors of Sexually Transmitted Infections in a Tertiary Hospital in Surakarta, Indonesia

2024-12-17T16:54:39+00:00

Background: Sexually transmitted infections (STIs) remain a significant public health concern globally, with millions of new cases occurring annually. Understanding the prevalence and risk factors associated with STIs is crucial for effective prevention and control programs. This study aimed to investigate the prevalence and risk factors of STIs among patients attending the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi General Hospital, a tertiary hospital in Surakarta, Indonesia.

Methods: A retrospective descriptive study was conducted using secondary data from medical records of patients diagnosed with STIs between January 2020 and December 2023. Data collected included sociodemographic characteristics, sexual behaviors, clinical diagnoses, and HIV status. Descriptive statistics and chi-square analysis were used to analyze the data.

Results: A total of 249 patients were diagnosed with STIs during the study period. The most common STI was condyloma acuminata (51%), followed by male genital discharge (18.1%), female vaginal discharge (16%), other STIs (10.9%), and genital ulcers (4%). The majority of patients were male (62.2%), aged 25-44 years (49.1%), had a high school education (49.5%), and reported heterosexual orientation (67.1%). Multiple sexual partners were reported by 62.7% of the participants, and 36.1% were HIV positive. The correlation analysis reveals that various sociodemographic, behavioral, and health-related factors are associated with different STIs.

Conclusion: Condyloma acuminata was the most prevalent STI among patients attending the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi General Hospital. The correlation analysis reveals that various sociodemographic, behavioral, and health-related factors are associated with different STIs. Understanding these correlations can help healthcare providers identify individuals at higher risk for specific STIs and implement targeted prevention and intervention strategies. Targeted interventions focusing on these high-risk groups are needed to reduce the burden of STIs in Surakarta, Indonesia.

Rare and Fatal Complication: A Case of Ketorolac-Induced Anaphylaxis Leading to Cardiac Arrest and Hypoxic-Ischemic Brain Injury in a Young Adult

2024-12-17T16:54:25+00:00

Background: Anaphylaxis is a severe, life-threatening allergic reaction that can lead to cardiac arrest and hypoxic-ischemic brain injury (HIBI). Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID) commonly used for postoperative pain management, has been rarely associated with anaphylaxis.

Case presentation: We present the case of a 32-year-old woman who developed anaphylaxis and subsequent cardiac arrest following intravenous administration of ketorolac after an appendectomy. Despite successful resuscitation, the patient suffered from HIBI and remained in a persistent vegetative state.

Conclusion: This report highlights the potential for fatal complications associated with ketorolac administration and emphasizes the importance of prompt recognition and management of anaphylaxis in the perioperative setting. This case underscores the need for heightened vigilance regarding potential anaphylactic reactions to ketorolac, even in patients with no prior history of drug allergies. Early recognition and aggressive management of anaphylaxis are crucial to minimize the risk of severe complications like cardiac arrest and HIBI.

Successful Epidural Anesthesia Management in Cesarean Section for a Patient with Eisenmenger Syndrome: A Case Report

2024-12-17T16:54:11+00:00

Background: Eisenmenger syndrome is a rare and complex condition that poses significant challenges for anesthesiologists during pregnancy, particularly during labor and delivery. The physiological changes associated with pregnancy, such as increased cardiac output and blood volume, can exacerbate the hemodynamic instability in these patients. Careful selection of anesthetic techniques and agents is crucial to maintain hemodynamic stability and ensure the safety of both mother and fetus.

Case presentation: We present the case of a 34-35-week pregnant woman with Eisenmenger syndrome who underwent a successful cesarean section under epidural anesthesia. The patient's hemodynamic parameters were closely monitored throughout the procedure, and no significant complications were encountered.

Conclusion: This case report demonstrates that epidural anesthesia can be a safe and effective option for cesarean section in patients with Eisenmenger syndrome. Meticulous planning, close monitoring, and prompt management of potential complications are essential for a successful outcome.

Behçet's Syndrome Treatment: A Meta-Analysis Comparing Efficacy and Safety of Immunosuppressants and Biologics

2024-12-18T16:55:32+00:00

Background: Behçet's syndrome (BS) is a chronic inflammatory disorder characterized by recurrent oral and genital ulcers, uveitis, and skin lesions. Immunosuppressants and biologics are commonly used to manage BS, but their comparative efficacy and safety remain unclear.

Methods: A systematic literature search was conducted in PubMed, Embase, and Cochrane Library databases from January 2013 to October 2024. Randomized controlled trials (RCTs) comparing immunosuppressants (azathioprine) and biologics (TNF-alpha inhibitors - infliximab, adalimumab, etanercept) in adult BS patients were included. The primary outcomes were clinical response rates (defined as improvement in disease activity scores) and adverse events. A random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs).

Results: Six RCTs (n=785 patients) met the inclusion criteria. Biologics demonstrated significantly higher clinical response rates compared to immunosuppressants (OR 4.57, 95% CI 3.26-6.40, p<0.00001). Infliximab, adalimumab, and etanercept showed superiority over azathioprine (OR 4.40, 95% CI 2.33-8.30, p<0.00001; OR 5.51, 95% CI 2.86-10.61, p<0.00001; OR 4.19, 95% CI 2.54-6.92, p<0.00001, respectively). Adverse events were comparable between groups, with no significant difference in serious infections or malignancies.

Conclusion: Biologics, particularly TNF-alpha inhibitors, are more efficacious than conventional immunosuppressants in inducing clinical response in BS, with similar safety profiles. These findings support the use of biologics as a first-line treatment option for moderate-to-severe BS.

Inflammatory Response in Stroke: A Comparative Leukocyte Analysis in Hemorrhagic and Ischemic Stroke Patients at a Single Center in Jambi, Indonesia

2024-12-18T16:55:18+00:00

Background: Stroke remains a leading cause of mortality and morbidity worldwide. Inflammation plays a crucial role in the pathophysiology of both hemorrhagic and ischemic stroke. This study aimed to compare total leukocyte counts (TLC) in hemorrhagic and ischemic stroke patients to assess the inflammatory response and its potential implications for clinical outcomes.

Methods: This retrospective study analyzed 74 stroke patients admitted to Abdul Manap Regional Hospital, Jambi, Indonesia, between January 2023 and December 2023. Patients were categorized into hemorrhagic (intracerebral hemorrhage) and ischemic stroke groups based on neuroimaging findings (CT scan or MRI). Demographic data, stroke severity (NIHSS score), and TLC obtained within 24 hours of admission were recorded. Independent t-tests and Mann-Whitney U tests were used for statistical analysis.

Results: The study included 38 ischemic and 36 hemorrhagic stroke patients. The mean TLC was significantly higher in the hemorrhagic stroke group (11.4 ± 3.5 x10^9/L) compared to the ischemic stroke group (9.5 ± 2.8 x10^9/L) (p = 0.021). No significant correlation was found between TLC and stroke severity (NIHSS score) in either group.

Conclusion: Hemorrhagic stroke patients exhibited a more pronounced early inflammatory response as evidenced by elevated TLC compared to ischemic stroke patients. Further research is needed to explore the prognostic value of TLC and the potential role of anti-inflammatory therapies in stroke management.

Anesthetic Management of a Pediatric Patient with Popliteal Pterygium Syndrome Undergoing Labiopalatoplasty: A Case Report

2024-12-19T16:55:43+00:00

Background: Popliteal pterygium syndrome (PPS) is a rare congenital disorder characterized by multiple anomalies, including orofacial, musculoskeletal, and genitourinary defects. Airway management in PPS patients can be challenging due to associated craniofacial abnormalities. This case report describes the anesthetic management of a 5-month-old infant with PPS undergoing labiopalatoplasty.

Case presentation: A 5-month-old male infant, weighing 5.9 kg, presented for labiopalatoplasty. He had a diagnosis of PPS with associated labiopalatoschisis, ankyloblepharon filiforme, pterygium in the popliteal fossa, cryptorchidism, and syndactyly. Airway assessment revealed a patent airway with a cleft lip and palate. Anesthesia was induced with sevoflurane and maintained with sevoflurane and nitrous oxide. Direct laryngoscopy was unsuccessful, and videolaryngoscopy was used to facilitate tracheal intubation.

Conclusion: This case highlights the challenges of airway management in infants with PPS. A thorough preoperative airway assessment and the availability of alternative intubation techniques, such as videolaryngoscopy, are crucial for successful anesthetic management in these patients.

Unraveling the Pathways: A Meta-Analysis Exploring the Biopsychosocial Mechanisms Linking Psychosomatic Symptoms and Systemic Lupus Erythematosus

2024-12-23T16:57:26+00:00

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by a complex interplay of biological, psychological, and social factors. Psychosomatic symptoms, such as depression, anxiety, and stress, are common in individuals with SLE and can significantly impact disease activity and overall well-being. This meta-analysis aims to explore the biopsychosocial mechanisms linking psychosomatic symptoms and SLE.

Methods: A systematic search of PubMed, Embase, PsycINFO, and Web of Science databases was conducted from January 2013 to December 2024. Studies examining the relationship between psychosomatic symptoms and SLE were included. Data were extracted and analyzed using random-effects models to calculate pooled effect sizes.

Results: Six studies met the inclusion criteria. The meta-analysis revealed a significant association between psychosomatic symptoms (depression, anxiety, and stress) and SLE disease activity (pooled effect size: r = 0.42, 95% CI: 0.31-0.53, p < 0.001). Furthermore, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, pro-inflammatory cytokine activity, and impaired coping mechanisms emerged as key biopsychosocial pathways linking these factors.

Conclusion: This meta-analysis highlights the significant impact of psychosomatic symptoms on SLE and identifies potential underlying mechanisms. These findings underscore the need for integrated biopsychosocial interventions in SLE management, targeting both physical and psychological well-being to improve patient outcomes.

Beyond Infection: The Role of Stunting in Tuberculosis Susceptibility and Treatment Outcomes

2024-12-23T16:57:12+00:00

Background: Tuberculosis (TB) remains a major global health concern, particularly in developing countries. Stunting, a manifestation of chronic malnutrition, is prevalent in these regions and is increasingly recognized as a significant risk factor for TB. This systematic review aims to comprehensively analyze the impact of stunting on TB susceptibility and treatment outcomes.

Methods: A systematic search of PubMed and ScienceDirect databases was conducted for studies published in the last 10 years, focusing on the relationship between stunting and TB. The PRISMA guidelines were followed for article selection and data extraction.

Results: The review identified a significant association between stunting and increased TB risk. Stunted individuals exhibit impaired immune responses, making them more susceptible to TB infection. Moreover, stunting negatively affects TB treatment outcomes, including increased treatment duration, higher relapse rates, and greater mortality risk.

Conclusion: Stunting is a critical determinant of TB susceptibility and treatment outcomes. Addressing stunting through comprehensive nutritional interventions is crucial not only for reducing the burden of malnutrition but also for enhancing TB prevention and control efforts.

A Case of Infectious Keratitis Associated with Rigid Gas Permeable Contact Lens Use in a Keratoconus Patient

2024-12-26T16:59:25+00:00

Background: Keratoconus is a non-inflammatory corneal ectatic disorder characterized by progressive corneal thinning and ectasia, leading to irregular astigmatism and visual impairment. Rigid gas permeable (RGP) contact lenses are often prescribed to manage keratoconus; however, improper use can lead to complications such as infectious keratitis.

Case presentation: We present a case of a 25-year-old female with keratoconus who developed infectious keratitis after three months of RGP lens wear. The patient presented with ocular discomfort, pain, photophobia, and redness in the left eye. Clinical examination revealed conjunctival and ciliary injection, a paracentral corneal infiltrate, and decreased visual acuity. Corneal pachymetry confirmed bilateral corneal thinning. The patient was diagnosed with bilateral keratoconus, bilateral compound myopic astigmatism, and left-eye infectious keratitis. Treatment included discontinuation of RGP lens wear, topical antibiotic therapy, and artificial tears. After two weeks of treatment, the corneal infiltrate resolved, and the patient was allowed to resume RGP lens wear with strict adherence to hygiene protocols.

Conclusion: This case underscores the importance of patient education and meticulous lens hygiene in preventing infectious keratitis and other complications associated with RGP lens wear in keratoconus patients. Regular follow-up examinations are crucial to monitor for signs of complications and ensure optimal lens fit. By adhering to these guidelines, clinicians can help to ensure the safe and effective use of RGP lenses in keratoconus patients.

Unraveling the Link between Obesity and Tuberculosis: A Systematic Review of the Underlying Mechanisms

2024-12-26T16:59:10+00:00

Background: Tuberculosis (TB) and obesity are significant global health concerns with potentially complex interactions. Obesity, through its effects on metabolism, inflammation, and the immune system, may influence TB susceptibility, progression, and treatment outcomes. This systematic review aims to analyze the published literature on the relationship between obesity and TB, focusing on the underlying mechanisms.

Methods: A systematic search of PubMed, Science Direct, and Google Scholar was conducted for articles published in the last 10 years. The search strategy included keywords such as "tuberculosis," "TB," "obesity," and "BMI." Articles were selected using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method.

Results: The review identified 11 studies that met the inclusion criteria. The studies revealed a complex relationship between obesity and TB, with nutritional status, immunity, and diabetes mellitus (DM) playing key roles. Obesity can alter the immune response to TB, potentially increasing the risk of disease and affecting treatment efficacy.

Conclusion: The relationship between obesity and TB is multifaceted, with obesity potentially influencing both disease susceptibility and outcomes. Further research is needed to fully elucidate the underlying mechanisms and to develop targeted interventions for individuals with both obesity and TB.

Ethnic Differences in Myopia: Axial Length and Central Corneal Thickness in the Minang Population

2024-12-28T16:59:28+00:00

Background: Myopia is a prevalent vision disorder characterized by blurred distance vision. It is often associated with increased axial length (AL) and alterations in central corneal thickness (CCT). This study investigated the relationship between AL and CCT in individuals from the Minang ethnic group in Indonesia with varying degrees of myopia.

Methods: A cross-sectional study was conducted at the Ophthalmology Clinic of Dr. M. Djamil General Hospital Padang from June to July 2024. The study involved 33 eyes from Minangkabau patients with myopia, categorized into three groups: mild, moderate, and high myopia. Axial length was measured using A-scan Biometry (immersion technique), and central corneal thickness (CCT) was assessed using Anterior Segment Optical Coherence Tomography (AS-OCT).

Results: Significant differences were observed in the average values of AL and CCT among mild myopia (AL 23.93 ± 0.650 mm, CCT 530.45 ± 38.534 µm), moderate myopia (AL 25.03 ± 0.516 mm, CCT 518.64 ± 26.223 µm), and high myopia (AL 27.12 ± 1.524 mm, CCT 509.45 ± 30.422 µm) groups, with a p-value of 0.037 (p<0.05) and r = -0.729. A strong correlation between AL and CCT was found in individuals with myopia among the Minangkabau ethnic group (r = -0.729, p = 0.037).

Conclusion: Higher degrees of myopia are associated with increased axial length and reduced central corneal thickness in the Minang ethnic group. These findings highlight the importance of considering ethnic differences in the assessment and management of myopia.

Iron Deficiency and Anemia of Inflammation in Tuberculosis: A Systematic Review of the Evidence

2024-12-28T16:59:14+00:00

Background: Tuberculosis (TB) remains a major global health problem, with anemia being a frequent comorbidity. Anemia in TB is multifaceted, with iron deficiency and anemia of inflammation (AI) being the most common types. This systematic review aims to synthesize the evidence on iron deficiency and AI in TB, their prevalence, impact on outcomes, and management strategies.

Methods: A systematic search of PubMed and ScienceDirect databases was conducted for articles published in the last 10 years. Observational studies examining the prevalence, types, and impact of anemia on TB outcomes were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

Results: The review included 7 studies involving 1,133 participants. Anemia prevalence ranged from 61% to 89% in TB patients. AI was the predominant type, with iron deficiency also prevalent. Anemia was associated with increased mortality, delayed sputum culture conversion, and impaired TB treatment response.

Conclusion: Anemia, primarily AI and iron deficiency, is highly prevalent in TB and negatively impacts treatment outcomes and survival. Effective management of anemia is crucial for improving TB outcomes. Further research is needed to optimize diagnostic and treatment strategies for iron deficiency and AI in TB.