Accreditation
SINTA 2Nationally Accredited Journal
Vol. 6 No. 12 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Validation of the Dash, Bhondave, and Gadekar Score System to Predict the Difficulties of Laparoscopic Cholecystectomy
Views: 667Downloads: 365Background: One of the treatment options for cholelithiasis is laparoscopic cholelithiasis. The challenge of this procedure is to determine the level of surgery.
Methods: This analytic cross-sectional study was conducted at Sanglah Hospital Denpasar from January 2019 to September 2020. Several risk factors data were assessed according to the Risk Scoring System for Laparoscopic Cholecystectomy. Receiver Operating Characteristic (ROC) curve was plotted to determine the cut-off score based on the most optimal sensitivity and specificity to predict the difficulty of surgery. Univariate statistical analysis was conducted based on the type of data with a p-value <0.05 considered significant.
Results: From a total of 62 laparoscopic cholecystectomies, 36 (58.1%) case was a simple surgery, and 26 (41.9%) was difficult surgery. In the difficult surgical group, 17 surgeries (27.4%) were more than 60 minutes, nine surgeries (14.5%) with bile spillage, and one surgery (1.6%) with ductal injury. The scoring system had a sensitivity of 86.1%, a specificity of 76.9%, a positive predictive value of 83.7%, and a negative predictive value of 80%.
Conclusion: A scoring system is a promising approach to estimating the difficulty of laparoscopic cholecystectomy. Further study to improve this scoring system is necessary.
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The Relationship between Accurate Use of Antibiotics and Clinical Improvement of Sepsis in Neonates Using the Gyssens Method in the Perinatology Ward of Dr. M. Djamil General Hospital, Padang Indonesia
Views: 732Downloads: 434Background: Neonatal sepsis is a major cause of neonatal morbidity and mortality in developing countries. Inappropriate use of antibiotics causes an increase in antibiotic resistance, so the Gyssens method is needed, which is a qualitative method and is used to evaluate the use of antibiotics. This study aims to determine the relationship between the accuracy of the use of antibiotics using the Gyssens method on the clinical improvement of neonates in the Perinatology Ward of Dr. M. Djamil General Hospital Padang, Indonesia.
Methods: This study used a cross-sectional conducted from January 2020 to December 2020. The study subjects were 67 neonates diagnosed with sepsis in the perinatology ward of Dr. M. Djamil General Hospital, Padang Indonesia. Data analysis was performed with SPSS for univariate and bivariate analysis.
Results: Most neonatal sepsis occurs in male infants who have low birth weight. Most cultures do not grow. There was an improvement in clinical and hematological parameters to the administration of first-line, second-line, and culture-appropriate antibiotics according to the Gyssens method, but statistically not significant (p-value > 0.05). The rational use of antibiotics was 89.6%.
Conclusion: There is a relationship between the accuracy of antibiotic use on clinical improvement and blood parameters of neonatal sepsis patients in the Perinatology ward of Dr. M. Djamil General Hospital based on the Gyssens method, but it is not statistically significant. The use of antibiotics based on the Gyssens method at Dr. M. Djamil General Hospital is quite good.
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Exacerbation of Psoriasis Vulgaris Induced by Vaccine COVID-19 in HIV Patient: A Case Report
Views: 1,028Downloads: 623Background: Psoriasis is a chronic and inflammatory skin disease. Many triggering factors can cause exacerbation of psoriasis, such as infection, trauma, and drugs. Several vaccines are known to cause new lesions or exacerbation of psoriasis, including Bacillus Calmette-Guerin (BCG), influenza, tetanus-diphtheria, and pneumococcal polysaccharide. In the COVID-19 pandemic, the COVID-19 vaccine is known to cause the appearance of new lesions or exacerbation of psoriasis.
Case presentation: A woman, 31 years old, came to the clinic with itchy reddish patches with white scales on her face, chest, stomach, back, arms, and both legs, and increased since 2 weeks ago. Previously, the patient got the first COVID-19 vaccine (Sinovac), and three days later, red patches appeared with white scales on the chest, stomach, and back. The patient had been diagnosed with psoriasis 3 years ago. Dermatology examination showed reddish patches with white scales on the face, chest, stomach, back, arms, and both legs. Auspitz sign and Kaarvetsvlek phenomen were positive. PASI score was 9,2. Dermoscopy examination showed red dot distribution on light pink background and white scales. She was treated with desoximetasone cream 0,05% twice a day and cetirizine tablet 10 mg once a day. After 2 months of therapy, reddish patches were decreased, and the PASI score was 6,9.
Conclusion: COVID-19 vaccine can cause exacerbations in psoriasis patients, but this vaccine can still be given to psoriasis patients. It is based on the documented efficacy of the COVID-19 vaccine in the prevention of severe COVID-19 infection and fatality. Psoriasis patients should be consulted before getting vaccinated for COVID-19, and prompt clinical visits should be available if exacerbation develops.
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Correlation of IL-17 Serum Levels with Carotid Intima-Media Thickness and Degree of Disease Activity in Rheumatoid Arthritis Patients at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia
Views: 641Downloads: 399Background: Rheumatoid arthritis (AR) is an autoimmune disease characterized by chronic and progressive systemic inflammation, in which the joints are the main target. AR has long been associated with increased cardiovascular risk. Vascular inflammation plays an important role in atherosclerosis. In AR, there is an increase in IL-17, which accelerate the formation of atherosclerosis. In Indonesia alone, there is no data that publishes the correlation between IL-17 levels with carotid IMT and the severity of AR.
Methods: This type of research is a descriptive observational study with a correlation test approach. A total of 31 subjects participated in this study who were AR patients and calculated a DAS score of 28. Carotid IMT was measured by high-resolution carotid Doppler ultrasound B-mode ultrasound machine (PHILIPS, iE33) equipped with an 11 MHz linear array transducer. IL-17 was measured by the ELISA method. Data analysis was performed with a correlation test with SPSS software version 25.
Results: There was a strong positive correlation between IL-17 and the degree of disease activity in AR (DAS28 score) with r = 0.657; p = 0.0001; n=31. There was no significant correlation between carotid IMT and IL-17 levels (r= 0,207; p=0,264; n=31).
Conclusion: There is a strong positive correlation between IL-17 and the degree of AR disease activity. There was no significant correlation between carotid IMT and IL-17 levels.
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Diagnosis and Management of Malignant Pleural Effusion: A Narrative Literature Review
Views: 1,973Downloads: 1,495Malignant pleural effusion (MPE) is defined as an effusion that occurs in association with malignancy, as evidenced by the finding of malignant cells on pleural fluid cytology or pleural biopsy. The pathophysiology of MPE is not yet clear, but several hypotheses have been developed to explain the mechanism of MPE. Accumulation of effusion in the pleural cavity occurs due to increased vascular permeability due to the inflammatory reaction caused by the infiltration of cancer cells in the parietal and/or visceral pleura. Other possible mechanisms are the direct invasion of the tumor adjacent to the pleura, obstruction of the lymph nodes, hematogenous spread, and primary pleural tumor. Pleural fluid from a malignant process is usually an exudate. To distinguish between exudate and transudate is to assess the protein and LDH levels of the pleural fluid. Hemorrhagic pleural fluid with a red blood cell count >100,000/mm3 suggests an MPE. Pleural fluid glucose levels at low < 60 mg/dl at about 15-20% MPE. The definitive diagnosis of MPE is by finding malignant cells in the pleural fluid (cytology) or pleural tissue (pathological histology). Management of malignant pleural effusions is principally palliative. Management that is often done in cases of MPE is therapeutic thoracentesis, pleurodesis, drainage with long-term indwelling catheter, manufacture of the pleuroperitoneal shunt, intrapleural therapy, and radiotherapy.
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Antibiotics Used in Leptospirosis: A Narrative Literature Review
Views: 1,014Downloads: 1,012Leptospirosis is an acute infectious disease that affects both humans and animals (zoonosis). This disease is caused by the Leptospira species, a bacterium with 250 serovar variations which thus detecting its cases is prominently challenging. In Indonesia, Leptospirosis is regarded as an iceberg phenomenon since such a challenge prevents this disease from being diagnosed in clinical practice, despite study data indicating that a significant percentage of reservoir rats in Indonesia are positive for Leptospira bacteria. As such, this disease has a high mortality of rats due to therapeutic delays. The usage of antibiotics is consequently considered an optimal therapy for leptospirosis. Antibiotics are chosen based on the clinical severity of the disease and should be administered as prophylaxis in high-risk groups in order to lower morbidity and mortality.
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Anaesthetic Management for Caesarian Section Complicated with Eisenmenger Syndrome Concomitant Severe Preeclampsia: A Case Report
Views: 888Downloads: 548Background: Although conception is discouraged in women with Eisenmenger syndrome, in inevitable circumstances, careful and meticulous planning of anesthesia can help the parturient survive the ordeal of a cesarean section. Anaesthetic management is aimed at avoiding haemodynamic changes that increase right-to-left shunt, thereby worsening hypoxemia. This study aimed to present a case of a pregnant woman with Eisenmenger syndrome who underwent caesarean section under general anesthesia management with severe preeclampsia.
Case presentation: A 42-year-old pregnant woman (gravida 3, para 1, abortion 1) was admitted to our hospital at 38 weeks gestation with the chief complaint of shortness of breath and severe preeclampsia. Physical examination revealed cyanotic with clubbing fingers and elevated jugular venous pressure. Laboratory investigations did not reveal any abnormalities. Electrocardiography (ECG) shows normal sinus rhythm and right atrial deviation. General anesthesia was chosen due to obstetric complications, namely severe preeclampsia. The patient was premedicated with a gastroprotective agent, ranitidine 150 mg. At follow-up anesthesia 36 hours after surgery, the patient scored for maximum perioperative comfort and satisfaction.
Conclusion: A multidisciplinary approach is needed to secure maternal and fetal survival for patients with Eisenmenger syndrome. Termination of Caesarean section under general anaesthesia may be the method of delivery that can be used, but care must be taken to avoid excessive and rapid blockade, dehydration, and hypoxaemia.
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Comparison of the Success Rate of Radial Arterial Cannulation with Palpation Techniques and Ultrasound Guidance in Patients Undergoing Major Surgery with General Anesthesia
Views: 959Downloads: 501Background: Ultrasound-guided arterial cannulation has the potential to increase the total success rate and first attempt and reduce complications compared to conventional landmark palpation methods. This study aims to compare the success rate of radial artery cannula with palpation techniques and ultrasound guidance in patients undergoing major surgery under general anesthesia.
Methods: This study is a randomized controlled trial singly. The inclusion criteria for this study were patients who underwent both emergency and elective surgery under general anesthesia, aged >18 years, with ASA I and II physical status. The study sample (60 people) was randomized by computer and divided into two groups (ultrasound guidance and palpation technique). The study will assess the success of the first insertion of the radial artery cannula in both groups. Data analysis was performed with SPSS 25 univariate and bivariate.
Results: There is a significant relationship with the success of the first attempt at an ultrasound-guided cannula trial with a p-value of 0.045 with an odds ratio of 3.33 with a 95% confidence interval (0.998 – 11.139).
Conclusion: Ultrasound-guided arterial cannulation has a better success rate and fewer complications than conventional palpation techniques.
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Diagnosis and Management of Chronic Appendicitis in Children: A Case Report
Views: 1,738Downloads: 704Background: Abdominal pain was one of the most complaints in children. Chronic appendicitis was the common cause of recurrent abdominal pain. The incidence of this case was 1,5% of all appendicitis cases. The manifestation was not specific, and one of the treatment options was surgical with laparotomy or laparoscopy methods.
Case presentation: A 10-year-old boy came to the outpatient clinic of gastroenterohepatology with a diagnosis of abdominal pain caused by chronic appendicitis differential diagnosis of chronic gastritis with abdominal pain, especially the pit of the stomach moving to the right waist since 3 months ago. Physical examination of the patient showed the general condition was moderate, conscious, and normal vital signs. Abdominal distension was absent, tenderness in the lower right abdomen was present, and the pain was present in the lower right abdomen. There was contralateral tenderness in the left lower abdomen. An appendicogram examination shows chronic appendicitis. The patient was consulted for pediatric surgery for appendectomy and later controlled to a surgical outpatient clinic after discharge.
Conclusion: Chronic appendicitis usually shows unspecific manifestation and physical examination. Early diagnosis and surgical treatment are options to treat appendicitis in children.
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Prepyloric Stricture in a 5-Year Old Infant Caused by Corrosive Injury: A Case Report
Views: 621Downloads: 24,730Background: The incidence of corrosive ingestion is high and largely unreported in developing countries due to lack of parental supervision and careless storing of these chemicals at home.
Case presentation: A 5 years, 1-month-old boy came to the outpatient clinic department of pediatric Dr. M. Djamil General Hospital with a chief complaint of recurrent vomit since 6 weeks before admission. There was a history of ingested accumulator water 1,5 months before admission. The patient vomits every day, especially after eating and drinking.
Conclusion: The most common symptoms are vomiting, feeding problems in oral intake, and rapid weight loss. The clinical diagnosis of prepyloric stricture is based on the history of the disease, physical examination, and supporting the investigation. Treatment of gastric outlet obstruction caused by corrosive ingestion should be treated surgically.
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The Role of Urinary Potassium Examination on the Progressivity of Chronic Kidney Disease: A Narrative Literature Review
Views: 583Downloads: 439Kidneys play an important role in potassium homeostasis. The important role of the kidneys in maintaining potassium balance is reflected in the high level of potassium disturbances in patients with decreased kidney function, especially patients with severely decreased renal function and patients who have comorbidities, such as diabetes, hypertension, or heart failure. Chronic kidney disease is characterized by abnormalities of kidney structure or function that persist for more than 3 months, have many complex causes, and have a major impact on global health status. There are several methods to measure the amount of potassium intake consumed, including a food frequency questionnaire, dietary recall, temporary urine potassium examination, and 24-hour urine potassium examination. The standard gold measurement for evaluating urinary potassium excretion is through 24-hour urine collection. This literature review aims to describe the role of urinary potassium excretion in assessing the progression of chronic kidney disease.
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Application of Topical Autologous Platelet-Rich Plasma for Treatment of Pemphigus Foliaceus Wounds: A Case Report
Views: 1,026Downloads: 590Background: Pemphigus foliaceus (PF) includes lesions on the skin, generally without involving the mucosa. Wounds in PF arise on the outer layer of the superficial skin, but if left untreated, the wound will not heal and will multiply. Platelet-rich plasma (PRP) containing a variety of different growth factors can be used in wound care. This study was at a time to describe autologous PRP therapy in the treatment of excoriated erosional wounds in patients with pemphigus foliaceus.
Case presentation: A woman, 35 years old, married, a housewife living in suburban, comes to the emergency department with complaints of blisters accompanied by pain in the face, body, and back which has been increasing since 1 month ago. Examination of the skin showed palpebral blisters on the eyelids of the left and right eyes. In the anterior and posterior trunk regions, proximal 1/3rd and suprapubic extremities, there are hyperpigmented erythematous macules, multiple, nummular-plaque, discrete, partially confluent, with white to brownish scales, single layer and exfoliative. In the posterior trunk region, Nikolsky's sign was positive. Laboratory evaluation showed an increase in leukocytes and neutrophils. ANA examination showed negative results and anti-ds-DNA 54.91. Management of pemphigus in the form of topical and systemic treatment. Topical management in the form of an open compress with 0.9% NaCl solution, Intrasite gel®, and closed Cutimed sorbact® for erosion and excoriation. Topical PRP was administered on the 7th day of treatment. On the 14th day after treatment with topical PRP, the patient is allowed to go home with the repair of lesions throughout the region.
Conclusion: PRP therapy in cases of pemphigus foliaceus is very useful in improving the clinical condition of the patient.
