Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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The Role of Percutaneous Ventricular Restoration Therapy in Heart Failure After Myocardial Infarction
Views: 505Downloads: 444The process of ventricular remodeling has a major role in the pathogenesis of heart failure in patients with myocardial infarction. Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), antialdosterone diuretics, and beta receptor blockers are drugs that have been widely accepted as anti-remodeling agents. However, sometimes the efficacy of these drugs is inadequate, or their use is constrained by low blood pressure. Percutaneous ventricular restoration therapy is an action that aims to exclude segments of the myocardium that have akinetic or aneurysms by implanting a ventricular partitioning device percutaneously. This technique is expected to prevent the progression of ventricular remodeling through a procedure with a lower risk of intraprocedural mortality than the surgical approach.
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Diagnosis and Management of Enthesopathy
Views: 803Downloads: 4,508Enthesopathy is inflammation of the enthesis. Outcome Measures in Rheumatologic Clinical Trials (OMERACT) defined enthesopathy as abnormal hypoechoic (loss of normal fibrillar architecture) and/or tendon or ligament thickening at the site of bone attachment (sometimes containing hyperechoic foci that resemble calcifications) seen in two perpendicular planes on Doppler and/or bony changes including ensophytes, erosions, and irregularities. The causes of enthesopathy are categorized into two, namely, non-inflammatory causes and inflammatory causes. Non-inflammatory causes include trauma, degenerative, autoimmune, genetic, and metabolic. The causes of inflammation areas in seronegative spondyloarthropathy.
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Effect of Aloe vera Hydrogel Application on Increasing the Number of Fibroblasts in Socket Wounds Post-Tooth Extraction: An In Vivo Study
Views: 984Downloads: 1,398Background. Aloe vera has been used as an anti-inflammatory, antimicrobial, and immune-boosting agent since ancient time. Hydrogel is a polymeric material that can retain a significant amount of water component and can last as long as possible in the gingival sulcus because the hydrogel is hydrophilic. This study is the first study that seeks to explore the potential of Aloe vera in healing socket wounds after tooth extraction.
Methods. Twenty-five white rats of the Wistar strain were acclimatized for seven days before being included in the study. After acclimatization, the experimental animals were grouped into five groups. Evaluation of fibroblast response process with HE staining.
Results. There were differences in the mean number of fibroblasts in all groups. From the results of this study, it can be stated that there is an effect of the application of hydrogel Aloe vera 1%, 2.5%, 5%, 10%, and xylazine on the increase in the number of fibroblasts in socket wounds after tooth extraction in Rattus novergicus.
Conclusion. There is an effect of Aloe vera hydrogel application on increasing the number of fibroblasts in socket wounds after tooth extraction in Rattus novergicus.
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Multigravid Women with Uterine Rupture: A Case Report
Views: 1,965Downloads: 945Introduction: Uterine rupture is the discontinuation of the uterine scar that creates connection between uterine and peritoneal cavity. The most common etiology for uterine rupture is dehiscence of uterine scar tissue from previous cesarean section. In patient with uterine rupture and fetal expulsion to the peritoneal cavity, fetal survival becomes extremely poor. Therefore, it is important for clinician to understand the uterine rupture and be able to give prompt treatment in order to prevent maternal and fetal morbidity and mortality.
Case Presentation: A 34-year-old woman, G3P2A0 38 weeks of gestation complained that she had abdominal pain, couldn’t feel her baby movement, watery discharge since 10 hours before admission. Bloody discharge and trauma were all denied. Patient underwent twice cesarean section before. Patient only had four times antenatal care with obstetrician at 24, 28, 32, and 36 weeks of gestation. She was scheduled for caesarean section at 38 weeks of gestation. Patient looked alert with low blood pressure and tachycardia. On physical examination, we found that she was pale, fundal height could not be determined, and there was no fetal heart rate detected. Speculum examination showed livide portio, closed external orifice of uterus, and inactive blood. There was positive slinger sign and Douglas cavity was bulging. Ultrasound examination showed intrauterine fetal demise, complete uterine rupture on lower segment, and positive sign of free fluid on abdominal cavity. Patient underwent operation and we found the died male neonate was in the peritoneal cavity and the placenta was still attached in the uterine cavity. We delivered the baby and placenta completely. There was uterine rupture on the previous CS scar, the edge of the uterine wound was regular with no necrosis and extended to the right side of uterus. Then, we performed hysterorrhaphy in order to stop the bleeding and repair the uterus, and we also performed tubal ligation. The died neonate had maceration grade I.
Conclusion: Uterine rupture causes poor fetal and maternal prognosis. Early diagnosis and prompt treatment is really important in uterine rupture. Prevention of uterine rupture could be done by meticulous antenatal care, especially visiting to obstetrician in order to review maternal and fetal condition and determine mode of delivery.
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Comparison of Short-Chain Fatty Acid (SCFA) and Interleukin-10 (IL-10) Levels in Patients with Systemic Lupus Erythematosus (SLE) Compared to Healthy Populations at RSUP Dr. Mohammad Hoesin Palembang
Views: 830Downloads: 534Background. Systemic lupus erythematosus (SLE) is a prototypical autoimmune disease with various significant diseases, where SLE can affect the entire population in the world. This study aims to compare and analyze differences in the composition of the gut microbiota of SLE patients compared to healthy controls based on SCFA examination in Indonesia.
Methods. The type of research conducted in this research is an analytical observational study with a case-control design. The research was conducted at Dr. RSUP. Mohammad Hoesin Palembang from October 2020 to October 2021. The sample in this study was divided into two groups, namely, the case group, and the control group. The case group was all SLE patients who met the inclusion criteria, while the control group was a healthy population who did a medical check-up at Dr. RSUP. Mohammad Hoesin Palembang. SCFA examination was carried out using Gas Chromatography-Mass Spectrometry (GCMS) from fecal samples.
Results. The results showed that there were two groups of SCFA values, namely the normal group and the microbiota dysbiosis group where the SCFA value was low or less than 4. in the SLE and normal populations where there were 6 SLE subjects who had normal SCFA values or 37.5% and there were 10 SLE subjects who experienced microbiota dysbiosis. or 62.5%. In the healthy population group, all subjects had SCFA values that were included in the normal category, namely 16 subjects or 100%. Based on the severity of SLE using the SLEDAI MEX score, all SLE patients in the study were in the active or category flare where the SLEDAI MEX score was > 5.
Conclusion. Patients with microbiota dysbiosis tended to have an LES of 7,222 or 7 times greater than patients who did not have microbiota dysbiosis or had normal SCFA values.
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Ductus Omphalocele Mesenteric Persisten: A Case Reports
Views: 608Downloads: 562Background: The ductus omphalomecenterica is a normal embryological structure where it serves to connect the midgut of the fetus to the yolk sac. Usually, this ductus will disappear at 9 weeks gestation. However, if this condition does not occur, then it can cause various anomalies to appear in the fetus.
Case Presentation: The patient was reported to be hospitalized with the chief complaint of choking. Echocardiography examination with the results of the examination found the presence of cyanotic congenital heart disease (CHD). The patient was referred to pediatric surgery with a diagnosis of persistent mesenteric duct omphalocele. Terminal ileum anastomoses resection laparotomy was performed.
Conclusion: After surgery due to complications of pneumonia and sepsis, the patient died.
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Relationship Between Vitamin D Supplementation and Improvement in Body for Carcinogenesis: A Literature Review
Views: 784Downloads: 742Vitamins are probably the best-selling dietary supplements in the United States, in which an estimated 35% of the population take multivitamin and mineral supplements. Data relating microconstituents to carcinogenesis are extremely limited, as explained in the first report. A striking feature of many of the compounds in the three groups mentioned above is their capacity to prevent or retard the occurrence of neoplasia. However, there is a paucity of data concerning the conditions under which inhibition occurs, the mechanisms of inhibition, and the precise impact of these microconstituents on humans. A literature review was conducted in the electronic databases PubMed and Google Scholar using the index terms "carcinogenesis" and "cancer" and "vitamin D" All types of studies were included for this study, such as randomized controlled trials, systematic reviews, literature reviews, and pilot studies published between 2010 and 2021. Articles which not written in English were excluded from the study. This search resulted in 10 papers. Many of the mechanisms proposed for vitamin D and cancer prevention have been studied only in the context of one tissue or one type of cancer and so further studies must be conducted to determine if these mechanisms can be generalized. For example, while higher serum (25(OH)D3) is associated with reduced cancer risk, and CYP27B1 is expressed in non-renal cells, there is no evidence that the low-level expression of CYP27B1 in tissues leads to meaningful local production of 1a,25(OH)2D3 or calcitriol, and that this mediates the protection from cancer provided by high vitamin D status. In conclusion, we suggest that vitamin D compounds to be employed in the treatment of, alone or in combination with other anticancer agents. solar UV-B radiation, acting through the production of vitamin D, is a risk reduction factor for over a dozen forms of cancer.
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Cardiac Disease in Pregnancy: Maternal and Perinatal Outcomes in RSUP Dr. Mohammad Hoesin Palembang
Views: 1,058Downloads: 590Background: Impaired maternal and uteroplacental perfusion can occur in pregnancy with cardiac disease leading to maternal and perinatal mortality and morbidity due to increased cardiac load and ventricular dysfunction. This research aims to determine maternal and perinatal outcomes of pregnancies with cardiac disease.
Method: This research was a descriptive observational study conducted by total sampling method and cross-sectional design. This research used medical records of pregnant women with cardiac disease who gave birth in RSUP Dr. Mohammad Hoesin Palembang in January 2018-December 2020 as study samples.
Result: Among 68 pregnancies with cardiac disease, there were 6 cases (0.87%) found in 2018, 38 cases (2.47%) found in 2019, and 24 cases (1.48%) found in 2020. The highest distribution of pregnancies with cardiac disease was found at 64.7% in the range of 20-35 years old age group; 57.4% in the multiparity group; 38.2% in the range of ≥34 – <37 weeks gestational age group; 86.8% in the high school educational level group; 66.2% in the high-risk cardiac functional status group; 54.4% in the peripartum cardiomyopathy group; and 36.8% with preeclampsia/eclampsia as a comorbid. In this study, maternal outcomes found were maternal mortality at 11.8%; cardiac failure at 70.6%; arrhythmia at 1.5%; and stroke at 1.5%, while perinatal outcomes found were prematurity at 60.3%; low birth weight at 64.4%; IUGR at 37.0%; IUFD at 1.4%; stillbirth at 6.8%; neonatal death at 9.6%; and perinatal asphyxia at 42.5%.
Conclusion: The prevalence rate of pregnancies with cardiac disease in RSUP Dr. Mohammad Hoesin Palembang was 0.87% in 2018, 2.47% in 2019, and 1.48% in 2020. The most common maternal outcome in this study was cardiac failure, with most in the peripartum cardiomyopathy group, while the most common perinatal outcome was low birth weight, with most in the hypertensive heart disease group.
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Disorder of Sex Development, Mosaic Genetic Disorder 45x, 46xy: A Case Report
Views: 1,289Downloads: 2,162Background. Disorder of sex development (DSD) is a congenital disorder associated with interference in chromosomes, gonads, or sexes anatomically. Individual affected with DSD can be recognized since birth due to external genital ambiguity. Sexual chromosome DSD occurred because sexual chromosome numeric or structural disorder. Mosaic karyotype 45X/46XY is among the rare sexual chromosome DSD with incidence less than 1:15,000 live births. DSD individuals are susceptible to stigmatization. This can cause stress, negative emotion, and social isolation. Therefore, DSD individual management should be done as optimal as possible.
Case Presentation: Twelve years old girl complaining a bump arose from anterior side of her genital resembles male genital since 4 years prior to admission without micturition and defecation complains. Patient has not experienced menarche. On external genital examination, we found the normal female external genital such as mons pubis, pubic hair, labia majora, labia minora, hymen, perineum, but without clitoris which in this case it is replaced by a glans of penis, arising from anterior commissure of labia majora area, with an urethral estuary. Before the management is done, patient underwent multidiscipline consultations and further examinations. Subsequently, it was approved that the joint conference formation consisting obstetric and gynecology, urologist, and pediatric endocrinologist to determine the optimal management for the patient.
Conclusion: In this case, diagnosis was made with history taking, clinical examination, and supporting investigation such as ultrasound imaging and could be followed by biochemistry test, voiding cystourethrography or genitogram to determine next management. Counseling should be done in detail towards the family to know what action is best for the patient. Multidiscipline team was required to get the optimum result either in medical, ethical, or religious point of view. Surgery in this case was considered followed by long term therapy afterwards.
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Relationship of Exclusive Breastfeeding with History of Acute Respiratory Infection (ARI) in Children Aged 0-24 Months in Siwalima Village in November 2021
Views: 831Downloads: 936Background. Acute respiratory infection (ARI) is a respiratory infection that affect both upper or lower respiratory tracts. The virus or bacteria causes ARI which lasts for 14 days. Indonesia had the highest mortality rate for ARI, in 2008 around 36.4% children infected; in 2009 around 32.1%; in 2010 around 18.2%; and in 2011 around 38.8%. The prevalence of ARI in Siwalima Health Center around 3240 children in 2020. Breastfeeding has huge benefit for both moms and babies. The prevalence of breastfeeding in Indonesia is 66.1%, but there are two provinces, West Papua (34%) and Maluku (37.2%) that have not reach the target yet. The purpose of this study is to find out if there is a relationship between Exclusive breastfeeding with history of Acute Respiratory Infection (ARI) in children in November 2021 in Siwalima Village, Aru Island, Maluku.
Methods. This study uses observational analytical research methods, and cross- sectional design. The subject of this study are children age 0 - 24 months and lived in Siwalima Village. The sample of this study is using total sampling technic and there are 186 respondents. Questioners with yes or no answer are using in this study.
Results. The result of chi-square test showed that there was a relationship between Exclusive breastfeeding with history of Acute Respiratory Infection (ARI) in children in November 2021 in Siwalima Village, Aru Island, Maluku. There are 84 respondent (45.2%) had ARI and 102 respondent (34.8%) didn’t, also 91 respondents (48.9%) didn’t receive exclusive breastfeeding and 95 respondent receive exclusive breastfeeding.
Conclusion. Breastfeeding can be increased, especially for children aged 0 – 6 months in order to prevent infection.
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Characteristics of Cholelithiasis Patients in Dr. Achmad Mochtar General Hospital Bukittinggi on January 2019 - December 2020
Views: 936Downloads: 1,078Background. Cholelithiasis is a condition where there are stones in the gallbladder or the common bile duct or both. This study aims to describe the characteristics of cholelithiasis patients in RSUD Dr. Achmad Mochtar Bukittinggi.
Methods. This research is a descriptive observational study on the incidence of cholelithiasis in hospitals. Dr. Achmad Mochtar Bukittinggi period January 2019 – December 2020. A total of 224 research subjects participated in this study. Secondary data was collected from medical records of research subjects, including data on age, gender, body mass index, clinical symptoms, and type of surgery. Data analysis was carried out with the help of SPSS 25 software.
Results. Cholelithiasis was most commonly found in the age group over 50 years (47.8%), normal BMI (46%) cases. The most complained symptom in cholelithiasis patients in this study was abdominal pain (61.6%). All cholelithiasis patients (100%) in this study underwent laparoscopic cholecystectomy surgery.
Conclusion. Cholelithiasis patients who underwent surgery in hospitals. Dr. Achmad Mochtar Bukittinggi for the period January 2019 – December 2020 were 224 patients. The majority of patients over 50 years of age, women, had a normal BMI. The patient frequently complained of abdominal pain and all had undergone laparoscopic cholecystectomy.
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Sepsis-Induced Diabetic Ketoacidosis (DKA) in Latent Autoimmune Diabetes in Adult (LADA)
Views: 1,284Downloads: 5,471Backgrounds. Latent autoimmune diabetes in adults (LADA) is a slowly progressive form of autoimmune diabetes mellitus characterized by older age at diagnosis, presence of pancreatic autoantibodies, and lack of absolute insulin requirement at diagnosis. Patients with LADA had better β-cell function than patients with classic Type 1 DM (T1DM). Overtime, LADA tends to experience rapid and progressive loss of beta cell function that requires intensive insulin therapy. This case report aims to describe a case of Diabetic Ketoacidosis (DKA) in a patient with latent autoimmune diabetes in adult (LADA) induced by sepsis (urinary tract infection/UTI).
Case Presentations. A woman, 28 years-old, came to the Emergency Department (ED) RSMH Palembang with chief complaints of decreased consciousness and shortness of breath. Patient had a history of frequent urination, pain when urinating, and fever. Urinalysis examination were glycosuria, proteinuria, hematuria. Hb-A1c level was 10.7%, C-Peptide 0.11 ng/dL, Anti GAD65 qualitative positive, and Islet cell antibody (ICA) negative. Patient was diagnosed with diabetic ketoacidosis (DKA), LADA, and sepsis due to urinary tract infection (UTI). Patients were managed with DKA and sepsis management algorithm.
Conclusion. Diabetic ketoacidosis (DKA) in LADA caused by sepsis is an emergency in the metabolic endocrine and diabetes fields. Prompt and appropriate management can improve outcome prognosis in this case.













