Accreditation
SINTA 2Nationally Accredited Journal
Vol. 7 No. 2 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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En Coup De Sabre in 16-Year-Old Girls: A Case Report
Views: 708Downloads: 1,034Background: En coup de sabre (ECDS) is one of the clinical variations of morphea. ECDS refers to a variant of linear morphea that usually involves the forehead and frontal scalp that may be associated with alopecia. This study aimed to describe a case of en coup de sabre with its diagnosis and management.
Case presentation: A girl, aged 16 years, came to the dermatology polyclinic with the main complaint of a sunken brown spot on the left forehead and corner of the left eye, which has been expanding since 2 months ago. This complaint does not feel itchy or painful, but because it is getting more widespread, patients feel embarrassed and often cover it up. On dermatological examination, depressed hyperpigmented macules, plaque size, firm boundaries, and location on the left medial superior lid and left medial glabella were found. On dermoscopy examination, a reticular pigment network obliterating the follicular opening was found. The results of the histopathological examination showed the impression of a linear morphea type with en coup de sabre. This patient was diagnosed with linear morphea type with en coup de sabre
Conclusion: En coup de sabre is a rare autoimmune disorder and is a subtype of morphea. Early detection and appropriate intervention will reduce disease progression.
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Allergy on HIV Infections: A Narrative Literature Review
Views: 969Downloads: 1,702HIV infection causes not only immune insufficiency but also immune dysregulation. Following HIV infection, cytokine profiles change, with a production of IL-4 rising along with IL-5 and a decrease in INF-g. This literature review aimed to describe allergy on HIV infection. At the initial phase after infection, cytokines produced by Th1 and Th2 are balanced, but later as the infection progresses, cytokines produced by Th2 will rise, while cytokines produced by Th1 will fall. Elevation of IL-4 will make B cells produce more IgE. Patients with even lower CD4 still have this allergic phenomenon caused by IgE. Allergic manifestations of HIV include rhinitis, asthma, adverse cutaneous drug reactions (ACDR), immune reconstitution inflammatory syndrome, hyperallergic state (IRIS), and atopic dermatitis. In conclusion, it is important to consider allergic manifestations even in AIDS patients, especially incidents of ACDR and IRIS, which can be life-threatening.
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The Role of Immunophenotyping in the Diagnosis of Acute Leukemia: A Narrative Literature Review
Views: 2,015Downloads: 943Leukemia is the expansion of leukocyte cells in the bone marrow, which results in an increase in the number of leukocyte cells in the blood circulation and abnormal cell proliferation in the lymphatic tissue. The diagnosis of leukemia is established based on anamnesis, physical examination, and laboratory and confirmed by supporting examinations such as bone marrow aspiration to immunophenotyping. This literature review aimed to describe the role of immunophenotyping in the diagnosis of acute leukemia. The working process of immunophenotyping consists of a group of cells stained with a fluorochrome-conjugated antibody as a dye that is targeted to antigens on the cell surface. Most of these antigens are assigned a cluster of differentiation (CD) numbers. In conclusion, immunophenotyping analysis using multiparameter flow cytometry is an essential tool in detecting leukemia. Immunophenotyping examination is very useful for determining the diagnosis of leukemia. Targeted therapy is one of the modalities of leukemia therapy that is selective for certain cells that can be given based on the results of immunophenotyping.
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The Role of Corticosteroids in the Management of Drug Allergy: A Narrative Literature Review
Views: 4,819Downloads: 1,207Drug allergy is an adverse drug reaction that occurs through an immune reaction that occurs through IgE or a rapid hypersensitivity reaction with various mechanisms and clinical presentations. One of the therapeutic modalities for drug allergies is corticosteroids. In allergic processes, corticosteroids can suppress the production and effects of humoral factors involved in the inflammatory response, inhibit the migration of leukocytes to sites of inflammation, and interfere with the function of endothelial cells, granulocytes, mast cells, and fibroblasts. This literature review aimed to describe the role of corticosteroids in the management of drug allergies. Corticosteroids are used very widely in the treatment of various allergic diseases because of their strong anti-inflammatory properties. Corticosteroids inhibit the synthesis of a number of cytokines, such as the interleukins IL-1 to IL-6, tumor necrosis factor-α (TNF-α), and granulocyte-macrophage colony-stimulating factor (GM-CSF). In conclusion, corticosteroids are one of the therapeutic modalities in various manifestations of drug allergies. Every drug allergy gets the anti-inflammatory effects of corticosteroids with different choices, routes, and doses for each manifestation.
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The Effects of Pancreatic Omentoplasty on Weight Loss, Improvement of Triglyceride and Interleukin-1 Levels in Obese Rats with Type II Diabetes Mellitus Performed Sleeve Gastrectomy
Views: 572Downloads: 373Background: Obesity can trigger inflammation or inflammatory disease, which is one of the main features of adipose tissue dysfunction. Adipose secretes several different peptides called adipocytokines, which can induce several pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1. Omentoplasty pancreas dan sleeve gastrectomy is a surgical technique that can treat overweight and metabolic syndrome in obesity and type II DM. This study aims to determine the effect of pancreatic omentoplasty on weight loss and improvement of triglyceride and interleukin-1 levels in rats obesity with type II diabetes mellitus performed sleeve gastrectomy.
Methods: This study is an experimental study in vivo. Eighteen rats participated in this study and were grouped into the control group (KI) and the KII and KIII treatment groups. Triglyceride levels were assessed using the spectrophotometric method, and IL-1 levels were assessed using the ELISA method. Data analysis was carried out using SPSS univariate and bivariate.
Results: The KII and KIII treatment groups experienced a decrease in body weight, triglyceride levels, and Interleukin-1 levels of rats after the treatment intervention, p<0.05. The KIII treatment group showed the most significant reduction in body weight, triglyceride levels, and Interleukin-1 levels compared to the KII treatment.
Conclusion: Pancreatic omentoplasty is effective in reducing body weight, reducing triglyceride levels, and reducing IL-1 levels in obese rats with type II diabetes mellitus undergoing sleeve gastrectomy surgery.
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Diagnosis and Management of Choledochal Cyst in One Year-Old Baby: A Case Report
Views: 685Downloads: 451Background: Choledochal cysts (CC) are rare congenital anomalies of the biliary tract. The classic triad of jaundice, abdominal pain, and right upper quadrant mass are rare symptoms, mainly in children and adolescents. This study aimed to present the diagnosis and management of choledochal cyst cases in a baby girl.
Case presentation: A 1-year-old girl, domiciled outside the city of Padang, was brought to the hospital by her parents with complaints of repeated vomiting for 1 day before being admitted to the hospital. This complaint has been accompanied by yellowish eyes and body, pale bowel movements, and dark brown urine since 3 months ago. The patient was never brought to the doctor for treatment. Since 1 month ago, the patient often feels pain in the abdomen and has a lump in the upper right abdomen. On the abdomen area, there was no distention, hepar was ¼-1/4 sharp edge, tenderness at the epicondrium area, no rebound tenderness, turgor was decreased, and no palpable mass. Abdominal ultrasonography presented a choledochal duct cyst with biliary obstruction. Abdominal CT scan with contrast revealed intrahepatic and extrahepatic biliaryectasis et causa suggestive of the choledochal cyst (Todani IVA) and hepatomegaly. The patient was consulted by the pediatric surgery division for further management and was advised to undergo surgery with the Roux En-y procedure. Follow-up after the patient underwent surgery showed clinical improvement. Symptoms of jaundice in the eyes and skin begin to decrease, as brownish stools and light brown urine.
Conclusion: Surgical treatment with the Roux-en-Y procedure is the definitive treatment for choledochal cysts in this patient.
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Central Diabetes Insipidus in Langerhans Cell Histiocytosis: A Case Report
Views: 757Downloads: 496Background: Diabetes insipidus (DI) is part of a group of hereditary or acquired polyuria and polydipsia diseases. Diabetes insipidus can be caused by central and nephrogenic disorders. This study aimed to describe the etiologies, clinical symptoms, and management of central diabetes insipidus in Langerhans cell histiocytosis.
Case presentation: A 4 years 4 months old boy came with excessive and frequent micturition since 9 months ago. The patient drinks 4-5 L per day and still feels thirsty. The patient had a history of Langerhans cell histiocytosis (LCH). During laboratory work-up, urine osmolarity decreased, and serum osmolarity and electrolyte were normal. The patient was diagnosed with central diabetes insipidus with Langerhans cell histiocytosis. The treatment given to the patient is desmopressin.
Conclusion: Langerhans cell histiocytosis may affect any organs of the body. The long-term management of diabetes insipidus in Langerhans cell histiocytosis requires measurement to prevent dehydration and, at the same time to prevent water intoxication. The focus of management is based on the education of the patient about the importance of regulating their fluid intake according to the patient’s hydration status.
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The Relationship between Serum Cystatin-C Levels and Impaired Cognitive Function in Patients with Chronic Kidney Disease
Views: 599Downloads: 403Background: Cystatin-C acts as a neuroprotector in the central nervous system at normal levels, but high serum cystatin-C levels are associated with impaired cognitive function. Serum cystatin-C levels increase in impaired renal function, and cognitive impairment are comorbidities that can increase the morbidity and mortality of chronic kidney disease patients. This study aimed to assess the relationship between serum cystatin-C levels and cognitive function in chronic kidney disease patients.
Methods: This study used a cross-sectional design with 73 samples of non-hemodialysis chronic kidney disease patients. Cognitive function was assessed using the MoCa-Ina. Serum cystatin-C levels of all samples were measured by the ELISA method. Data analysis was carried out using SPSS.
Results: Impaired cognitive function in CKD patients was found to be 76.7%. The median serum cystatin-C level of CKD patients with impaired cognitive function (n=56) was 1.015 mg/dL, and without cognitive impairment (n=17) was 0.929 mg/dL. There was no significant relationship between serum cystatin-C levels (cut-off point 0.98 mg/dL) and impaired cognitive function (OR : 2.05, 95% CI : 0.680-6.175, p= 0.198).
Conclusion: There is no relationship between serum cystatin-C levels and cognitive function impairment in non-hemodialysis chronic kidney disease patients.
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Transfusion-Related Acute Lung Injury (TRALI): A Narrative Literature Review
Views: 1,635Downloads: 1,492Transfusion-related acute lung injury (TRALI) is defined as the onset of respiratory distress in a patient after receiving a blood component transfusion. So far, TRALI is considered a rare complication in the field of blood transfusion. However, in the last decade, there has been a shift in perspective. Currently, the US Food and Drug Administration recognizes the syndrome as the leading cause of transfusion-related death. This literature review aims to describe TRALI and its prevention strategies. Understanding the pathogenesis of TRALI drives prevention strategies from a blood bank perspective. A major breakthrough in efforts to reduce the incidence of TRALI was excluding female donors from the high plasma volume product, which resulted in an approximately two-thirds reduction in incidence. However, this strategy has not completely eliminated complications of transfusion. In recent years, research has identified patient-associated risk factors for the development of TRALI and empowered clinicians to take an individualized approach to patients requiring transfusion.
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Management of Resistance to Targeted Therapy in EGFR Mutational Lung Adenocarcinoma: A Case Report
Views: 505Downloads: 428Advances in diagnosis and treatment have enabled a targeted therapy approach to inhibit tumor progression and provide a favorable prognosis. One of the targeted therapies in non-small cell lung cancer (NSCLC) is tyrosine kinase inhibitor (TKI) in mutations epidermal growth factor receptor (EGFR). This study aimed to present a case with the management of resistance to targeted therapy in EGFR-mutated lung adenocarcinoma. Data shows median progression-free survival patients on TKI therapy at 10 to 14 months. Progressive caused by resistance to TKI and assessed using response evaluation criteria in solid tumors (RECIST) 1.1. and confirmed by repeat biopsy. Reported a male patient aged 66 years with adenocarcinoma of the right lung EGFR deletion exon 19 mutation and received afatinib therapy for 16 months. Patients experience oligo progressive in the 13th month of therapy and systemic progression 16th month.
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The Relationship between Dickkopf-Related Protein-1 (DKK-1) Plasma Levels and Impaired Cognitive Function in HIV Patients
Views: 644Downloads: 415Background: Dickkopf-related protein – 1 (DKK-1) is an antagonist protein to the Wingless (Wnt)-β catenin signal. Dysregulation of Wnt-β catenin signaling by DKK-1 causes disruption of neuronal synapses, which can result in impaired cognitive function. Impaired cognitive function in people with HIV or HIV-associated neurocognitive disorder (HAND) is a spectrum of cognitive disorders related to HIV neuroinvasion and neuroinflammation, which significantly results in impaired cognitive function and daily activity. This study aimed to assess the relationship between plasma DKK-1 levels and impaired cognitive function in HIV patients.
Methods: This study used a cross-sectional design, consisting of 84 HIV sufferers who went to the voluntary counseling and testing (VCT) polyclinic at Dr. M. Djamil General Hospital, Padang, Indonesia, in the period December 2022 - March 2023, who met the inclusion and exclusion criteria. Cognitive function was assessed using the Montreal Cognitive Assessment Indonesian version (MoCa-Ina), and daily activity function using the instrumental activity of daily living (IADL) examination. Plasma DKK-1 levels were measured using the enzyme-linked immunosorbent assay (ELISA) method.
Results: The mean plasma DKK-1 level of HIV sufferers was 358.4 (+ 157.6) pg/mL. ANI type disorder was found in 78.6%, MND in 21.4%, and no HAD type. There was a significant relationship between plasma DKK-1 levels and impaired cognitive function in HIV patients (OR = 2.82, CI95% = 1.128-7.043, p = 0.025), but there was no significant difference in plasma DKK-1 levels between types of cognitive impairment ANI and MND (p = 0.858).
Conclusion: Plasma DKK-1 levels are significantly associated with impaired cognitive function in HIV patients.
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Delayed Bochdalek Diaphragmatic Hernia Appearance and Coincidence with Pneumonia in One-Year-Old Baby: A Case Report
Views: 743Downloads: 666Background: Congenital diaphragmatic hernia (CDH) is a developmental defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity. The incidence rates showed that this disease happened to one in 2,200-3,000 births. This study aimed to describe a case of delayed Boschdalek diaphragmatic hernia and coincidence with pneumonia in a one-year-old baby.
Case Presentation: A 12-month-old girl came to the emergency room of Dr. M. Djamil General Hospital with a chief complaint of breathlessness for 2 days before admission to the hospital. She had difficulty gaining weight, only about 200 grams per month. The symptoms are breathlessness, cyanosis, asymmetry of lung sounds, change in the position of the heart sound, and scaphoid abdomen. The chest X-ray showed the opacity loops, which are fluid-filled, suggestive left diaphragmatic hernia.
Conclusion: Pneumonia-like symptoms and signs could be an initial or coincidence with delayed presentation of Bochdalek hernia diaphragmatic.
