Accreditation
SINTA 2Nationally Accredited Journal
Vol. 6 No. 8 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Successful Long-Term Monitoring of Children with Scrofuloderma, Malnutrition, and HIV
Views: 761Downloads: 508Background: Scrofuloderma is a skin TB that occurs percontinuitatum from tissues underneath, such as lymph nodes, muscles, and bones. It often affects children and young adults. The incidence of TB disease is estimated to increase 20-fold in children with HIV infection. Poor nutrition can affect the mortality rate of children with HIV infection. This case report presents long-term monitoring of boys aged 1 year 5 months with scrofuloderma, malnutrition, and HIV infection. The case report aims to assist children and caregivers in undergoing treatment to prevent drug withdrawal and nutritional procedures and monitor the growth and development of children.
Case presentation: A 1-year and 5-month-old boy with a complaint of ulcers on his right neck since 12 months ago. He also complained of diarrhea 12 months ago, accompanied by recurrent stomatitis and progressive weight loss since 3 months ago. He looked pale 1 month ago. Blood laboratory examination with hemoglobin 5.1 gr/dl, leukocytes 5280 / mm3, platelets 323,000 / mm3, hematocrit 20%, reactive anti-HIV test, CD4 examination with a value of 178 cells / L, negative tuberculin test, a chest x-ray showed infiltrate in both lung fields, and bajah examination of the nodules in the Colli dextra region, with the impression of granulomatous inflammation that can be caused by mycobacterial infection.
Conclusion: Tuberculosis is the most common opportunistic infection found in children with HIV infection and increases the mortality rate. There is a relationship between nutritional status and the incidence of mortality in HIV/AIDS children, so it is necessary to monitor children for adherence to treatment, improve nutritional status and reduce morbidity and mortality rates.
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High Altitude Pulmonary Physiology
Views: 1,188Downloads: 2,543High altitude is defined as regions above 2400 meters above sea level. Almost 2% of the world’s population dwells in high-altitude regions of the world. The respiratory system plays an important role in determining survival and undergoes a series of adaptive changes to compensate for hypobaric hypoxic states (decreased barometric pressure with increasing altitude) including increased alveolar ventilation, diffusion capacity, pulmonary vascular vasoconstriction, increased cardiac output, shifted of oxyhemoglobin dissociation curve and polycythemia. Being at a high altitude suddenly without compensation can be bad and cause medical problems that will arise when at an altitude due to a decrease in PaO2 caused by a drop in barometric pressure.
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Risk Factors Related to Pneumonia in Toddlers in the Jeuram Health Center Work Area, Nagan Raya Aceh Regency
Views: 997Downloads: 580Background: Pneumonia has several risk factors, including low exclusive breastfeeding for infants, immunization status, smoking parents, and mother's level of knowledge related to pneumonia. This study aims to analyze the relationship between risk factors and pneumonia in toddlers in the work area of the Jeuram Health Center, Seunagan District, Nagan Raya Regency.
Methods: This research is an observational study with a cross-sectional design. The participants in this study were all mothers with toddlers in the working area of the Jeuram Health Center, with a total sample of 99 mothers. The sampling technique used was total sampling. Data analysis using SPSS.
Results: Based on the results of statistical tests, it was concluded that the factors related to the incidence of pneumonia in toddlers in the working area of the Jeuram Health Center, Nagan Raya Regency, namely knowledge (p-value 0.017), immunization status (p-value 0.041), exposure to cigarette smoke (p-value 0.033).
Conclusion: Knowledge, immunization status, and exposure to cigarette smoke are associated with the incidence of pneumonia in toddlers.
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Overview of Discharge Plan Strategies in Rural and Remote Areas: A Narrative Literature Review
Views: 890Downloads: 519Discharge planning is a systematic process that includes assessment, preparation, and coordination and involves various disciplines to provide optimal service. In Indonesia, there are 62 underdeveloped areas that have limitations in health services. Discharge planning in remote areas requires adaptation to be accepted in the community. This review aims to find an effective patient discharge strategy to be implemented in rural areas. Telepharmaceuticals and telerobots act as discharge planning interventions in remote areas. Remote monitoring, such as a pharmacological intervention in late life (PILL) program that focuses on monitoring the treatment of patients with polypharmacy. Interprofessional education and collaborative practice (IPECP) is suitable to be carried out in remote areas where limited facilities stimulate health workers to collaborate. Patient activation measure (PAM) to assess the ability and engagement of patients in maintaining their health. In addition, interventions were found in the form of making patient-centered guidelines in the form of ROADMAP (rural options at discharge - model of active planning).
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A Deadly Spontaneus Hemopneumothorax: A Case Report
Views: 905Downloads: 490Background: Spontaneous hemopneumothorax (SHP) is a subtype of hemopneumothorax in which there is an accumulation of blood and air in the pleural space without trauma or other definitive cause. Spontaneous hemopneumothorax is a rare disease.
Case presentation: A man, aged 32 years, came with a complaint of sudden shortness of breath due to a right hemopneumothorax patient who was put on a chest tube insertion. It looked like 1500 cc of blood came out accompanied by an air component. Next, the chest tube is connected to the water-sealed drainage. The patient found a decrease in Hb from 15 mg/dl to 12 mg/dl. In the next nine hours, the patient's Hb became 10 mg/dl. As a result of this condition, the patient underwent an emergency thoracotomy to evaluate the source of bleeding, where the patient's source bleeding was found to be an arterial vein malformation (AVM) at the apex of the lung attached to the chest wall. Anatomical and pathological examination showed confirmed arterial vein malformation.
Conclusion: Spontaneous hemopneumothorax, in this case, is a rare case caused by arterial-vein malformation. The right decision in patient management will determine the outcome and outcome of the treatment given.
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Relationship between Hormonal Contraception and Menstrual Cycle
Views: 1,590Downloads: 844Background: The high rate of baby births in Indonesia increase in population each year. Family planning is a way to regulate the number of children and birth spacing between children with contraception. Injection and pill contraceptives are hormonal contraceptives. However, the use of contraceptives has an impact on weight gain, nausea, vomiting, headaches, and swollen feet. Dusun Kepuk is one of the villages in the Bangsri sub-district with the domination used of hormonal contraception compared to other methods, and the side effects of using this hormonal contraceptive method are not known. The aim of the research was to determine the relationship between the use of hormonal contraceptives and changes in the menstrual cycle in Kepuk Village, Bangsri District, Jepara Regency.
Methods: This was non-experimental research with a cross-sectional design conducted in Kepuk Village, Bangsri District, Jepara Regency. The population in this study were acceptors who used hormonal contraception (pills and injections). The samples were taken with purposive sampling based on the inclusion and exclusion criteria. This study used a questionnaire to obtain information from respondents. The data were analyzed using the SPSS chi-square correlation test.
Results: Most respondents with 3 months of injected contraceptives suffer a disrupted menstrual cycle, as many as 51 respondents (71.8%). The Chi-Square test result p = 0.001 show that there is a relationship between the use of hormonal contraceptives and the menstrual cycle.
Conclusion: The use of hormonal contraception is associated with changes in the menstrual cycle changes in Kepuk Village, Bangsri District, Jepara Regency.
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Extraintestinal Amoebiasis: Amebic Liver Abscess in a 48-Year-Old Male Patient
Views: 898Downloads: 982Background: The liver is the most common organ for abscesses. Liver abscesses can be solitary or multiple. Approximately 90% of right-lobe liver abscesses are solitary abscesses, while only 10% of left-lobe abscesses are solitary abscesses. This can occur from hematogenous spread or directly from the site of infection in the peritoneal cavity.
Case presentation: A 48-year-old male patient had been administered into the internal medicine ward with the chief complaint of pain in the upper right quadrant of the abdominal increased 3 days before being admitted to the hospital. The patient also complains that pain increase when the patient moves forward and is influenced by activity. The patient walked like a person who carried his stomach. The patient complained of watery stools 3 months ago in ten days, which frequency two to three times a day. The stools are bloody and slimy. Swelling of an upper right quadrant of abdominal since 1 month ago. Decrease of appetite since 1 month ago. Decrease of body weight since 1 month ago, about 5 kilograms. Fever since 2 weeks ago, not high, disappearing, no chill, no sweat. Nauseous since 1 week ago. The patient was admitted to the hospital with awareness of compos mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 120/80 mmHg, pulse rate 86 times/minute, regular pulse, adequate filling, respiratory rate 24 times/minute, temperature 37ºC. On physical examination, the conjunctiva of the patient’s eyes was anemic. Entamoeba histolytica was found on a routine stool examination.
Conclusion: The main clinical manifestations of amoebiasis are right abdominal pain can be features of iron deficiency anemia and reactive thrombocytosis. Diagnosis is based on the finding of characteristic Entamoeba histolytica in the stool. Metronidazole 500 mg three times daily dose resulted in 80% cure and a dose of 750 mg/three times daily for 10 days gave 100% cure. Treatment of reactive thrombocytosis is by curing the basic disease.
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Efficacy of N-Acetylcysteine (NAC) Against Malondialdehyde (MDA) Levels in Diabetic Cataracts: In vivo Study
Views: 1,117Downloads: 1,790Background: Diabetes mellitus is a systemic condition that affects various organs, including the eyes. N-acetylcysteine (NAC) functions as an antioxidant because it belongs to a thiol group synthesis glutathione. However, the availability of cysteine in the body is only 15%, so cysteine supplementation can help with oxidative stress in diabetic cataracts. That it will prevent the reaction of lipid peroxidase and the formation of PUFA in the lens membrane, which causes damage to lens cells and is characterized by an increase in malondialdehyde. This study aims to determine the comparison of malondialdehyde levels in the lenses of diabetic cataract rats given or without topical NAC.
Methods: 36 rats were divided into the control group (received streptozotocin) and treatment group (received streptozotocin and topical NAC. Intraperitoneal injection of streptozotocin was given 90 mg/kg BW and performed once a week for 3 weeks. GDP examination was performed the next day after the rats fasted for 16 hours from the vein. In the tail, GDP > 110 mg/dl categorized as diabetes. Topical NAC was given 4 times per day for 3 weeks. At the end of the study, the lens was extracted for the measurement of malondialdehyde.
Results: The mean MDA levels in the control group were higher (2.90±0.71nmol/ml) than in the treatment group (2.33±0.38nmol/ml), p<0.05.
Conclusion: NAC was effective in reducing oxidative stress levels in diabetic cataract lenses by lowering MDA levels better than the group that did not receive MDA in vivo.
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Effectiveness Diagnosis of Pulmonary Tuberculosis (TB) in Children Based on Clinical Symptoms
Views: 1,867Downloads: 949Background: Diagnosis of pulmonary tuberculosis (TB) in children is still a challenge because the gold standard by examining sputum AFB is difficult. This study aimed to see the effectiveness of diagnosing TB in children based on clinical symptoms.
Methods: This study is a retrospective study with a case-control design, and consecutive sampling from the medical records of pediatric TB patients at Panembahan Senopati Hospital, Bantul for the period January 2014 - December 2016. The total population is 90, and the sample is 73. Children diagnosed with a score (score 6) are in the control group (n=30), while children with a diagnosis score of <6 were diagnosed with pulmonary TB based on clinical symptoms, we categorized them into the case group (n=43).
Results: There was no difference in gender, age, and group domicile. However, there was no significant difference in nutritional status (malnutrition), long cough, and chest X-ray. The difference between the two groups was found in symptoms of fever and enlarged lymph nodes. Also, it was found in TB contacts and the Mantoux test but this could be a recall bias because in the diagnosis group this is rarely done. The sequential scoring parameters from the most common were chest X-ray, malnutrition, cough, enlargement of lymph nodes, fever, contact TB, and the Mantoux test. Improvement of symptoms (cough, fever, lymph nodes, and chest X-ray) after 6 months of therapy occurred 100% in both groups.
Conclusion: The diagnosis of TB in children based on clinical symptoms can be used as an effective alternative.
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Lactating Adenoma in Pregnancy: A Case Report
Views: 997Downloads: 615Background: Lactating adenoma is a rare palpable breast lesion that occurs late in pregnancy or the lactation period and is commonly found in young primiparous women in the second or third decade of life. This case report aims to describe lactating adenoma and its management.
Case presentation: A woman, 24 years old, 26 weeks pregnant, came to the Surgical Oncology Polyclinic of Dr. Moewardi Hospital Surakarta with a complaint of a lump in the right breast from the last 4 months. The lump was felt to be getting bigger, painful to the point that sometimes fluid came out of the nipple of her right breast. The patient had a history of previous lumps with a diagnosis of fibroadenoma that had been operated on. On palpation multiple nodules are palpable. Mammography examination showed a mass with partial calcification (BIRADS 3). The patient was diagnosed with a tumur of mammae dextra suspected of malignant cT2N1Mx with G1P0A0 26 weeks gestation. Histopathological examination results showed a lactating adenoma.
Conclusion: There are several recommendations for the management of lactating adenoma during pregnancy. An antepartum biopsy is recommended for women with a breast mass in the first or second trimester, postpartum for masses that appear in the late third trimester, and fine-needle aspiration biopsy as an alternative for masses that appear in the early third trimester. Treatment with bromocriptine, a dopamine agonist, may be given to reduce the size of the lactating adenoma.
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The Relationship between Germ Patterns and Severity of Diabetic Ulcers Based on Wagner's Score at Dr. M. Djamil General Hospital Padang
Views: 669Downloads: 377Background: Diabetes Mellitus (DM) is a condition of increasing blood sugar levels which increases the risk of macrovascular and microvascular damage, thereby reducing the quality of life of the sufferer. One of the common complications in people with diabetes mellitus is diabetic ulcers. The classification system commonly used to determine the degree of diabetic ulcers is Wagner's criteria, which consists of 5 degrees of severity. Diabetic wounds become a place for bacterial growth and the production of exudate, which results in a longer healing process and causes tissue damage.
Methods: This study is a cross-sectional analytic observational study in diabetic ulcer patients treated at Dr. M. Djamil General Hospital Padang. The sampling technique in this study was consecutive sampling. The subjects of this study amounted to 36 people, with the majority aged >50 years and the female sex being found more than the male. Data analysis was performed using SPSS version 25 through univariate and bivariate analysis.
Results: The grades of diabetic ulcers in the treated patients ranged from mild to severe. All subjects in this study had monomicrobial results. Gram-negative bacteria were the most commonly found, namely, 77.8%. In this study, there was no significant relationship between bacterial patterns and the severity of diabetic ulcers based on Wagner in patients treated at Dr. M Djamil General Hospital Padang (p-value > 0.05).
Conclusion: Klebsiella sp is the most common type of bacteria that causes diabetic ulcers. No polymicrobial bacteria were found in this study. No correlation was found between the pattern of germs and the severity of diabetic ulcers in patients treated at Dr. M Djamil General Hospital, Padang.
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Comparison of Breast Massage (Oxytocin Massage, Oketani Massage, and Marmet Massage) Against the Smoothness of Breast Milk from the Aspect of Baby's Sleep Frequency
Views: 1,743Downloads: 1,323Background: The inability to meet breast milk production can be prevented in various ways, one of which is breast massage. The breast massage technique, at a certain point, is able to remove the blockage of blood vessels and energy blockages so that it will facilitate milk production. This study aims to determine the potential of breast massage (oxytocin massage, oketani massage, and marmet massage) to smooth breast milk from the aspect of the baby's sleep frequency.
Methods: Study design method experimental with the control group. Samples were Primiparous postpartum mothers who gave birth normally and were divided into three groups, namely oxytocin massage intervention group, marmet massage, oketani massage, and control group. Data were analyzed in univariate, bivariate, and multivariate.
Results: Breast massage (oxytocin, marmet and oketani) in primiparous postpartum mothers was effective in increasing the frequency of baby’s sleep. The frequency of the baby’s sleep before Marmet massage was 3.29 hours, and after Marmet massage was 5.29 hours. In the oxytocin massage intervention group, it was known that the average sleep frequency of babies before breast massage was 2.00 hours, and after breast, massage was 3.00 hours. Furthermore, in the Oketani massage intervention group, it was found that the average frequency of the baby’s sleep before breast massage was 2.00 hours, and after breast, massage was 3.00 hours. In the control group, it is known that the average sleep frequency of babies before breast massage is 0.57 hours and after breast massage is 0.71 hours.
Conclusion: Oxytocin massage, marmet massage, and oketani massage have been shown to be effective in improving the smoothness of breast milk from the aspect of the baby's sleep frequency.
