Accreditation
SINTA 2Nationally Accredited Journal
Vol. 5 No. 10 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Comparison of Chest X-Ray Findings Between Primary and Secondary Multidrug Resistant Pulmonary Tuberculosis
Views: 3,952Downloads: 3,063Introduction: Radiological imaging has a key role in multidrug-resistant (MDR) pulmonary tuberculosis (TB) screening and diagnosis. However, new cases of MDR pulmonary TB are often overlooked; therefore, its transmission might continue before its diagnosis. The most widely used and affordable radiological modality is a chest radiograph. This study aims to describe the characteristics of primary and secondary MDR pulmonary TB chest x-ray findings for differential diagnosis.
Methods: This study was an analytic observational study with a retrospective design. Researchers evaluated medical record data of primary and secondary MDR pulmonary TB patients who underwent chest x-ray examinations. The patient's chest x-rays were then evaluated. Evaluated variables were lung, pleural, and mediastinal abnormalities and severity category.
Results: The most common chest x-ray finding in primary MDR pulmonary TB was consolidation (96.2%), which was mostly unilateral (52.0%), accompanied by cavities (71.2%), most of which were multiple (83.8%) with a moderate category of severity. The most common chest x-ray finding in secondary MDR pulmonary TB was consolidation (100%), which was mostly bilateral (60.4%), accompanied by cavities (80.2%), most of which were multiple (90.1%) with severe category of severity. Pleural thickening (47.5%) was also found.
Conclusion: There was a significant difference between primary and secondary MDR pulmonary TB in terms of mild severity category, and pleural thickening. Mild severity category is mostly found in primary MDR-TB and pleural thickening is mostly found in secondary TB.
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Philogenetic Analysis of S. Scabiei Var. Hominis, Var. Cuniculi, and Var. Marmoota
Views: 1,086Downloads: 625Introduction: Based on data from the 2017 Global Burden of Disease, it is known that Indonesia is the country with the highest number of scabies incidences out of 195 countries in the world. In addition to humans, scabies is also an infectious disease in mammals with a prevalence of 300 million infestations every year, even in animals the mortality rate from scabies is very high. Until now, it is still unclear whether there is a cross-infestation between human and animal scabies. Morphologically, S. scabiei between variants cannot be distinguished, while research on genetic variation is still not much done. Therefore, it is necessary to conduct studies to enrich genetic information and phylogenetic analysis.
Methods: The samples tested were positive PCR results for ITS 2 and CO 1 genes, each on five amplicons, namely three S. scabiei var. hominis, one var. cuniculi, and one var. marmoota. Phylogenetics were arranged based on the closeness of the base arrangement in variants and geographically available in NCBI.
Results: Of the five sample isolates studied, the ITS 2 gene amplicon is located in the 417bp band and the phylogenetic analysis of its sequencing has two branches that are unable to distinguish var. hominis and var. animalia. The CO1 gene has electrophoretic results at 317 bp as well as phylogenetic analysis results that specifically divide branches between var. hominis and var. animalia.
Conclusion: S. scabiei var. hominis and var. marmoota, and var. cuniculi are distinct species and are host monospecific.
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Screening for Cervical Cancer
Views: 1,410Downloads: 1,507Screening is a public health intervention administered to a target population without symptoms. Screening is not performed to diagnose a disease, but to identify individuals with a higher likelihood of developing the disease itself or a precursor to the disease. Not all diseases are suitable for screening programs. The following criteria help determine whether a disease is suitable for a screening program: (1) The disease is bound to have serious consequences. (2) The disease must have a detectable preclinical and asymptomatic stage. (3) Treatment at the preclinical stage should influence the long-term course and prognosis of the disease being screened. (4) Care must be available and accessible to those who have a positive screening test. History, screening tests and treatment options for cervical pre-cancer meet these criteria.
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The Most Dominant Predictability Factor of Boey Score on The Level of Mortality in Perforation Gaster Boey Score 1 and Boey Scores 2 Patients in RSUD Dr Soetomo Surabaya
Views: 1,669Downloads: 868Introduction: The Boey score is the most commonly used scoring system for risk stratification because of its simplicity and high predictive value for mortality and morbidity in cases of gastric perforation. This score is widely used in daily practice because it only assesses 3 assessment components; namely the onset of perforation, shock at first admission, and comorbid disease; which is easy to do and has a fairly good accuracy. In Boey score 2, the mortality rate is still high, so research on the factors that most influence mortality at Boey Score 2 needs to be done.
Methods: This study uses secondary data from medical records of patients who meet criteria of inclusion and exclusion. This study is a comparative test using a cohort analytic observational study design (longitudinal retrospective), comparing the components of the Boey score which is the most influential in predicting the mortality rate in gastric perforated patients. Boey score 1 and Boey score 2 at RSUD Dr. Soetomo Surabaya
Results: Total subject of the study was 65 people, consisting of 43 men (66.2%) and 22 women (33.8%). The Boey score was 16 people (24.6%) with a Boey score of 1 and 49 people (75.4%) with a Boey score 2.From the Boey score component, 49 people (75.4%) were obtained with the onset of perforation> 24 hours, 31 people (47.7%) with preoperative shock, and 34 people (52.3%) with comorbidities. Comorbidity in study subjects included hypertension in 17 people (26.2%), diabetes mellitus in 4 people (6.2%), heart disease in 4 people (6.2%), lung disease in 5 people (7.7%), and kidney disease in 7 people. people (10.8%)
Conclusion: Shock is the most dominant Boey Score predictability factor that affects the mortality rate in gastric perforation patients with Boey score 1 and Boey score 2. -
Correlation between Lgr5 Expression and 5-FU based Chemotherapy Response in Stage IV Colorectal Cancer Patients
Views: 1,163Downloads: 759Background. Colorectal cancer is the third commonest malignancy and the second leading cause of cancer death in the world. 5-Fluorouracyl-based chemotherapy is the primary treatment modality for colorectal cancer. Cancer stem cells are known to be responsible for chemotherapy resistance. Lgr5 is a colorectal cancer stem cell marker that is the target gene for Wnt signaling. Lgr5 potentiates the Wnt signaling pathway through inhibition of a regulator that inhibits Wnt signaling. Lgr5 overexpression is associated with a worse prognosis and chemotherapy resistance. This study was aimed to investigate the correlation between Lgr5 expression and 5-FU-based chemotherapy response in stage IV colorectal cancer patients at Dr. Mohammad Hoesin Hospital Palembang.
Methods. This study used a correlative analysis study with a retrospective design using secondary data from medical records and paraffin blocks of stage IV colorectal cancer patients who received 5-FU-based chemotherapy from September 2018 to September 2020. The number of samples was 30 subjects consisting of 22 cases of negative responses and eight positive responses. All samples were stained with Lgr5 immunohistochemistry. Data analysis used the contingency coefficient correlation test.
Results. Of the 30 research subjects, 20 subjects (66.7%) had high Lgr5 expression and ten subjects (33.3%) with low Lgr5 expression. Correlation analysis using the contingency coefficient test showed a weak correlation between Lgr5 expression and 5-FU based chemotherapy response with a positive direction, which means the higher the Lgr5 expression, the less response to chemotherapy.
Conclusion. There is a weak correlation between Lgr5 expression and 5-FU based chemotherapy response in stage IV colorectal cancer patients at dr.Mohammad Hoesin Hospital Palembang. -
The Relationship between Recurrence Rate and Molecular Subtypes of Breast Cancer in Locally Advance Breast Cancer (LABC) Post Mastectomy: Focus on Comparison of Luminal A and Luminal B
Views: 1,434Downloads: 793Background. Breast cancer is the highest prevalence of malignancy for women in Indonesia and important national health problem. Estimated 2 million women developed breast cancer in 2018 with a mortality rate of 14.1 in every 100,000 women. Regarding the relationship between subtypes and breast cancer recurrence Several studies on gene expression have shown several subtypes of breast cancer, including the two most important subtypes, estrogen receptor (ER) positive (Luminal A and Luminal B) and ER negative (Triple negative and Her2 positive). Based on the explanation above, currently there is no data in Soetomo Hospital that discusses the role of breast cancer subtypes as a prognostic factor in determining the recurrence rate in locally advanced breast cancer.
Methods. The research design is an associative test using a retrospective cohort observational analytical study design, associating the relationship between tumor subtypes with recurrence in locally advanced breast cancer patients after mastectomy and has received additional therapy according to standard procedures at Dr. Soetomo Surabaya This study used secondary data from the medical records of the Oncology Polyclinic, RSUD Dr. Soetomo Surabaya from 2014 to 2019.
Results. The research subjects who have been selected according to inclusion criteria are 214 people, with the proportion in the population of luminal A and luminal B subtypes of 107 people each. Based on this study, it was found that the subtype was positively correlated with recurrence in LABC patients who had undergonecmastectomy with a significance value of p = 0.000 (p <0.05; 99% CI).
Conclusion. There is a relationship between the recurrence rate and the molecular subtype of breast cancer in locally advanced breast cancer (LABC) patients after mastectomy at Dr Soetomo Hospital. -
Comparison of Recurrence Rates in Patients with Locally Advanced Breast Cancer after Mastectomy and Received Aromatase Inhibitor Therapy with Steroids and Nonsteroids
Views: 973Downloads: 606Introduction. Breast cancer is a problem that is still faced throughout the world. The incidence of cancer in Indonesia is at number 8 in Southeast Asia. The incidence of breast cancer in women is 42.1 per 100,000 population. Aromatase inhibitors are hormonal therapy used in postmenopausal breast cancer with positive ER and/or positive PR. The third generation aromatase inhibitors are divided into 2 categories, namely non-steroidal agents that are reversible and steroid agents that are irreversible. Based on existing studies, there are no consistent research results regarding the incidence of recurrence after aromatase inhibitor therapy, both steroids and non-steroidal.
Methods. This study is an analytical observational study with a retrospective cross-sectional design using secondary data from medical records. The research was carried out at the Surgical Clinic of RSUD dr. Soetomo Surabaya on October 1, 2020 until the end with the subject of LABC patients at POSA Surgery RSUD Dr. Soetomo who has undergone mastectomy and radiotherapy and has received adjuvant hormonal aromatase inhibitor therapy for 2 years from January 2018 to January 2020.
Results. In the nonsteroidal aromatase inhibitor group, 18 subjects (60%) experienced recurrence and 16 subjects in the steroid aromatase inhibitor group (32%) with an OR of 0.314 (0.12-0.81; p=0.014. Based on the results of multivariate analysis, it was found that the increased risk of recurrence was significantly affected only by the administration of aromatase inhibitor p= 0.052
Conclusion. Women with locally advanced breast cancer after mastectomy who received aromatase inhibitor steroid therapy had a 0.314 times lower risk of recurrence than those who received non-steroidal aromatase inhibitor therapy.
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Clinical Correlations Delirium and other Comorbid in Elderly with COVID-19 Infection
Views: 1,302Downloads: 628Background. Delirium is a common condition in geriatric patients. One of the trigger factors for this condition is an infection, such as COVID-19 infection. Elderly with COVID-19 show atypical symptoms such as delirium. Elderly patients with COVID-19 who present with delirium, either as a primary symptom or showing symptoms or signs, have a poor prognosis. This study were aimed to presents covid-19 elderly patient with comorbid delirium.
Case presentation. A 77-year-old woman with disorientation for one day came to Emergency Department with her family. She had no history of headaches, blurred vision, or seizures. However, she had a fever, did not want to eat for three days, and had a purulent decubitus ulcer. The patient was diagnosed with acute delirium syndrome, confirmed COVID-19 with sepsis, malnutrition, hypercoagulation, grade III decubitus ulcer, suspected dementia, immobilization, total dependence. The patient admitted to the isolation ward. The patient had meropenem 500 mg every 12 hours, anticoagulants and favipiravir according to the dose and parenteral nutrition.
Conclusion. Patients with COVID-19 who present with delirium, either as a primary symptom or presenting symptoms or signs, have a worse outcome. Delirium relationship with comorbid factors can increase mortality and morbidity in the elderly with COVID-19.
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The Role of Extracorporeal Membrane Oxygenation on Acute Respiratory Distress Syndrome
Views: 940Downloads: 1,939Acute lung injury and acute respiratory distress syndrome are characterized by rapid-onset respiratory failure following a variety of direct and indirect insults to the parenchyma or vasculature of the lungs. Extracorporeal membrane oxygenation is a form of extracorporeal life support where an external artificial circulator carries venous blood from the patient to a gas exchange device (oxygenator) where blood becomes enriched with oxygen and has carbon dioxide removed. This blood then re-enters the patients circulation. The potential advantages of ECMO over conventional manajement may extend beyond its role in supporting patients with ARDS. ECMO may facilitate and enhance the application of lung-protective ventilation by minimizing ventilator-induced lung injury.
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Condylomata Acuminata in Adolescent Girl 19th Years Old Successful with Multimodality Therapy and Combination with HPV Vaccination: A Case Report
Views: 2,082Downloads: 3,215Background: Condylomata acuminata (KA) or better known as genital warts disease is a genital area infectious disease caused by Human papilloma virus (HPV). The highest prevalence infection of the condylomata acuminata occurs during active sexual periods, namely age 17-33 years, with the peak occurring at the age of 20-24 years. Currently HPV 16 and 18 are known to cause malignancy in the genital and anogenital region including cervical cancer and anal cancer, while HPV 6 and 11 are the cause of 90% of condylomata acuminata. HPV is linked to the findings of 500,000 new cases of cervical cancer and 250,000 deaths from cervical cancer each year worldwide.1
Case report: One case of condylomata acuminata in a 19-year-old adolescent girl with a major complaint of warts around her genitals that felt itchy and gradually getting bigger since 2 weeks ago. Patient was a student and unmarried. History of sexual contact with men with genito-genital without using condoms since 5 months ago. Venereological state : on the vulva and perineal there were multiple vegetations with verucose surfaces with the largest size 0.8 cm x 0.5 cm x 0.1 cm and the smallest size 0.2 cm x 0.2 cm x 0.1 cm. Acetowhite examination result was positive and PCR examination results found positive HPV types 6,11,16 and 18.
Discussion: Patients are diagnosed to condylomata acuminata with a history of free sex at an early age. The condylomata acuminata experienced by patients was type 6,11,16 and 18. These types of 16 and 18 HPV are know to cause malignancy in the genital and anogenital region including cervical cancer and anal cancer.
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The Efficacy of Genistein-Rich Edamame as a Prevention of Atherosclerotic Lesion in Abdominal Aorta: Study in Rats Model of Atherosclerosis
Views: 1,470Downloads: 883Background: Atherosclerosis is the main cause of ischemic heart disease which leads to death for people aged more than 40 years old. Genistein is an important isoflavone compound which may protect the blood vessels from endothelial injury. This research is to observe the efficacy of genistein rich edamame as a prevention for atherosclerotic abdominal aortic lesions that seen from abdominal aortic thickness and foam cells count.
Method: Thirty rats were divided randomly into five groups and treated for 28 days. The negative control group was given food and drink ad libitum. The positive control group was induced for atherosclerosis using adrenaline 0.006 mg / 200 gr BW injected on the first day and then the next day was given egg yolk 5 gr / 200 gr BW on next day for 28 days. All of the treatment groups were induced for atherosclerosis and treated with genistein-rich edamame extract 5 mg / 200 gr BW, edamame extract 38 mg / 200 gr BW and atorvastatin 1.5 mg / 200 grBW. Data were analyzed using One Way ANOVA - post hoc Bonferroni test, Kruskal Wallis - Mann Whitney test, and Pearson correlation test.
Results: There were significant differences (p<0,001) in abdominal aortic thickness and foam cells count between positive control group and treatment genistein-rich edamame extract, edamame extract and atorvastatin. There was a significant correlation between the abdominal aortic wall thickness and foam cells count (correlation coefficient value 0,753; p<0,001).
Conclusion: The administration of genistein-rich edamame extract can prevent the thickening of abdominal aorta and foam cell formation. Genistein-rich edamame can prevent foam cells formation better than atorvastatin.
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Late Onset Hypocalcemia Caused by Hypovitaminosis D
Views: 933Downloads: 819Background: hypocalcemia is a common metabolic problem in neonates and infants that can be life threatening. The incidence of hypocalcemia leads to complications and developmental disorders in children.
Case presentations: A 1 month-old boy with hypovitaminosis D and a history of recurrent hypocalcemia since one week of age. The patient had repeated seizures at the age of 7 days without fever and hypoglycemia, the overall physical examination was within normal, the results of the lumbar puncture were within normal limits. Laboratory examinations at that time showed low of serum calcium, urinary calcium, calcium ion and vitamin D levels, while magnesium, phosphorus and parathyroid hormone (PTH) levels were within normal limits. The patient was diagnosed with late onset hypocalcemia caused by hypovitaminosis D. The patient was given vitamin D therapy, calcium lactate, and intravena calcium correction was performed.
Conclusion: late onset hypocalcemia occurring after the first 7 days of life was associated with hyperparathyroidism, high phosphate formula administration, DiGeorge syndrome, hypomagnesemia, and vitamin D deficiency.
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Regulation and Intervention of Intracranial Pressure
Views: 1,431Downloads: 1,863Intracranial pressure is the total amount of pressure exerted by the brain, blood and cerebrocinal fluid in the rigid cranial space. Compliance is an indicator of the brain's tolerance for increased ICP, when compliance is exceeded, there will be a dramatic increase in the pressure/volume curve so that ICP will increase rapidly. In the injured brain, cerebral blood flow (CBF) is regulated to supply sufficient oxygen and substrates to the brain. Certain physiological factors such as hypercarbia, acidosis and hypoxemia cause vasodilation which causes an increase in CBF, seizure activity and fever will increase the level of brain metabolism and CBF. Cerebral edema is the most common cause of non-traumatic brain injury such as central nervous system infections, metabolic and systemic encephalopathy. Vasogenic brain edema occurs due to injury to the blood-brain barrier and increased capillary permeability in the area around the injury, or to inflammation, especially in CNS infections. Medical management of elevated intracranial pressure includes sedation, cerebrospinal fluid drainage, and osmotherapy with either mannitol or hypertonic salts.
