Accreditation
SINTA 2Nationally Accredited Journal
Vol. 7 No. 3 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
-
Management of Pulmonary Tuberculosis in Liver Cirrhosis: A Case Report
Views: 1,277Downloads: 775Background: Anti-tuberculosis drugs (OAT) are metabolized in the liver and have a high potential for hepatotoxicity, and will increase the risk of drug-induced liver injury (DILI). This study aimed to describe the management of pulmonary tuberculosis in patients with cirrhosis of the liver.
Case presentation: 45 years old male patient with cough with phlegm for 5 months, weight loss. The patient is also known to have cirrhosis of the liver. From the results of the bacteriological examination, it was found that TCM mtb was detected as high. The patient has risk factors for low BMI, a history of alcohol, hypo albumin, and comorbid hepatic cirrhosis. This patient was given a hepatoprotection. After liver function improved, the patient was started on anti-tuberculosis drugs with a regimen of 2 hepatotoxic drugs, namely isoniazid, rifampin, and ethambutol, given gradually and planned to be given for 9 months, with regular monitoring of liver function in the first 2 months.
Conclusion: Effective management of pulmonary tuberculosis infection depends on giving OAT at the appropriate dose and duration. The selection of regimen and duration of therapy can be considered based on the condition of chronic liver disease. Careful assessment and periodic evaluation of liver function are required.
-
Asthma as a Protective Factor against COVID-19 Infection: A Narrative Literature Review
Views: 616Downloads: 394Asthma and COPD comorbidities are expected to exacerbate the clinical manifestations of COVID-19. However, many reported studies show that asthmatic patients infected with COVID-19 do not show severe clinical manifestations, and some are asymptomatic. This literature review aimed to describe COVID-19 in asthmatic patients along with the hypothesis that asthma is a protective factor against COVID-19 infection. Systemic corticosteroids have been shown to reduce the death/mortality rate in patients who are hospitalized due to COVID-19 infection. This is possibly due to the suppression of the immune system against a hyperinflammatory state which can result in further damage from SARS-CoV-2 infection. Mucus hypersecretion, which is one of the hallmarks of asthma, can prevent the SARS-CoV-2 virus from reaching the distal lung and can protect the lungs from pathological processes. The secreted mucus is rich in glycoproteins, such as MUC5AC, which act as the first line of defense against infection. Mucus hypersecretion in asthmatic patients may prevent SARS-CoV-2 from penetrating far enough to gain access to type-2 alveolar cells, which are the cells that predominantly express ACE2 in the lungs. In conclusion, comorbid asthma in patients infected with COVID-19 does not cause adverse clinical manifestations to appear, but on the contrary, it will have a protective effect on patients.
-
A Henoch-Schönlein Purpura Case with Clinical Manifestation of Gastrointestinal Bleeding: A Case Report
Views: 940Downloads: 501Background: Henoch-schӧnlein purpura (HSP) or also known as immunoglobulin A (IgA) vasculitis, is an autoimmune vasculitis of small blood vessels. The incidence of HSP in adults is only 5 in 100,000 adult patients. One of the causes of these low incidences is due to misdiagnosed or underdiagnosed. This is inevitable as in adults, and the disease usually presents with atypical signs and symptoms. One of the rare manifestations of this disease is gastrointestinal tract bleeding. This study aimed to describe a case of Henoch-schӧnlein purpura with gastrointestinal bleeding and the treatment.
Case presentation: A rare case of a 20-year-old adult male diagnosed with HSP with the chief complaint of severe abdominal pain and gastrointestinal bleeding was presented. The patient also complained of arthralgia. Upon closer examination, the patient had palpable purpura on both the ankle and trunk. Urinalysis showed protein (+2) with erythrocyte 25-50 cells. Esophagogastroduodenoscopy showed erosive pangastritis, bile reflux, and duodenal submucosal bleeding with a normal duodenal bulb. The patient was diagnosed with HSP and was given methylprednisolone and azathioprine. On 1 month follow-up, the patient's complaints subside.
Conclusion: Henoch-schӧnlein purpura should be considered in adult patients, especially in patients with skin lesions without thrombocytopenia accompanied by multiorgan involvement (gastrointestinal, renal, and joint).
-
Overview of Interleukin-6 Levels in COVID-19 (Coronavirus Disease 2019) Patients at Dr. M. Djamil General Hospital, Padang, Indonesia
Views: 691Downloads: 386Background: COVID-19 infection can cause an exaggerated immune response. This immune response is associated with an increase in proinflammatory cytokines, especially interleukin-6 (IL-6). High IL-6 levels are found in the acute stage of COVID-19, and IL-6 can induce an excessive humoral inflammatory response. This study aimed to provide an overview of IL-6 levels in coronavirus disease 2019 (COVID-19) patients at Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: Descriptive observational study of 102 research subjects. Observations on sociodemographic, clinical, and laboratory data were carried out in this study. Univariate analysis was carried out using SPSS version 25.
Results: Patients with symptom onset <7 days had higher IL-6 levels than those with an onset of more than 7 days. Patients with critical degrees have the highest IL-6 levels compared to moderate and severe degrees. Patients with more than 1 comorbid had higher IL-6 levels than patients who had no comorbid or only had 1 comorbid. Patients with <21 days of treatment had higher IL-6 levels than patients with more than 21 days of treatment.
Conclusion: COVID-19 patients at Dr. M. Djamil General Hospital, Padang, Indonesia, with an onset of less than 7 days, a critical degree, and more than 1 comorbidity have higher IL-6 levels.
-
The Role of Nutritional Therapy in Inhibiting the Progression of Chronic Kidney Disease: A Narrative Literature Review
Views: 919Downloads: 502The need for proper nutrition and diet is fundamental in every stage of chronic kidney disease. The principle of nutritional therapy is slowing the progression of chronic kidney disease, delaying patients with CKD (chronic kidney disease) from getting kidney replacement therapy. In CKD patients, there is a disturbance of protein homeostasis, disturbance in metabolism protein, acid-base disorders, and hormonal dysfunctions. As the progression of CKD increases, nitrogen-containing products accumulate, causing a decrease in appetite. In CKD patients, intestinal absorption is also impaired because uremia causes microbiota disturbance and damage to the intestinal epithelium. These various things cause nutritional status to become often irregular, and protein energy wasting frequently occurs, thus requiring dietary adjustments in patients with CKD. In conclusion, each individual with CKD has a different nutritional therapy approach depending on the disease conditions and nutritional status of the individual. Appropriate nutritional therapy in CKD patients can reduce disease progression.
-
The Effect of UVB Exposure at Collagen Density and Dermal Thickness of Wistar Rats: A Pilot Study
Views: 1,816Downloads: 1,491Background: Skin aging has been characterized by decreasing skin regeneration and loss of structure and function. The most significant cause of extrinsic skin aging is exposure to ultraviolet (UV) radiation (80%). UVB radiation causes DNA damage which leads to dermal thickness reduction. This study aimed to compare the features of collagen density and dermal thickness of rats before and after UVB exposure.
Methods: This experimental study was conducted at the experimental animal laboratory of Universitas Setia Budi, Surakarta, from May to June 2022. The male Wistar rats were epilated and given UVB exposure, and a back skin biopsy was performed before and after the total dose of UVB exposure. The UVB exposure dose was 50 mJ/cm2 in the first week, 60 mJ/cm2 in the second week, and 70 mJ/cm2 in the third and fourth weeks. The UVB tool used was the Kernel® UV Phototherapy KN-4003BL UVB lamp.
Results: The collagen densities before vs. after total dose UVB exposure are 61.9% vs. 50.3% for 4x magnification and 63.8% vs. 49.6% for 10x magnification. The dermal thickness also reduced from 1422.07 ± 1165.96 µm before the total dose of UVB exposure to 1049.52 ± 1018.97 µm after the total dose of UVB exposure.
Conclusion: UVB exposure can induce decreased collagen density and dermal thickness in Wistar skin rats, similar to photoaging.
-
Characteristics of Adult Sepsis Patients Admitted to Department of Internal Medicine, Dr. M. Djamil General Hospital, Padang, Indonesia
Views: 1,013Downloads: 614Background: Sepsis is a life-threatening organ dysfunction resulting from a dysregulated host response to infection. Septic shock is the most dangerous complication of sepsis, characterized by abnormalities in the circulatory and metabolic systems. This study aimed to determine the characteristics of adult sepsis patients admitted to the department of internal medicine of Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: This research was a descriptive study and used secondary data from medical records. Samples in this study were medical record data from the medical record installation of Dr. M. Djamil General Hospital, Padang, Indonesia. The inclusion criteria were adult patients aged more than 18 years old, diagnosed with sepsis, and hospitalized in the department of internal medicine for the period of January 2020 to December 2021.
Results: Most of the sepsis patients were mostly aged more than 60 years old (51.7%), female (57.2%), and had normal BMI scores (59.3%). The infections mainly originated from the lungs (80%), the most common comorbid disease was chronic kidney disease (26.4%), the most frequent causing microorganism was Escherichia coli (15.9%), the frequent degree of severity was a septic shock (60%), and cefepime was used as the initial empirical antibiotic (44.8%).
Conclusion: Most sepsis patients were adults aged more than 60 years old and females, with the focus on infection originating from the lungs, degree of severity in the form of septic shock, and the most used initial empirical antibiotic, namely cefepime.
-
Clinical Grading of Corneal Ulcer and Its Management in Dr. M. Djamil General Hospital, Padang, Indonesia
Views: 1,109Downloads: 1,547Background: Infectious corneal ulcer (CU) occurs due to an agent, which may be a bacterial, fungal, or viral microorganism. A detailed examination of the ulcer was needed to determine the severity grading of the ulcer. Based on the size, depth of ulcer, density of infiltrate, and scleral involvement, it's divided into mild, moderate, and severe grades and may be used to objectively monitor the progress of the ulcer and as a parameter for management. Medical management includes topical, systemic antibiotic, and periocular injection, while amniotic membrane transplantation (AMT), conjunctiva flap, fascia lata, and evisceration as surgical. This study aimed to assess the clinical grading associated with the management of CU in Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: Observational analytics based on the medical record of corneal ulcer patients in Dr. M. Djamil General Hospital, Padang, Indonesia, in 2016-2017. A total of 191 research subjects participated in this study. Data analysis was carried out using SPSS univariately.
Results: The fungal, bacterial, and viral CU was diagnosed clinically. The severity grading that we found is moderate (60,73%), mild (25,14%), and severe (14,13%). All of the cases used medical treatment. Surgical was performed in moderate (36,59%) and all severe cases. AMT was performed in severe cases with perforation ≤ 4 mm and perforation > 4 mm conjunctival flap (3.7%), fascia lata (3,7%), and evisceration (61,53%), preferably.
Conclusion: The clinical grading of corneal ulcers in our hospital is moderate, and it may be associated with our hospital as a referral hospital. Surgery was performed in all severe and moderate cases that don't respond well to medicine.
-
The Outcome of Concurrent Intracameral Fluconazole Injection with Amniotic Membrane Transplantation for Fungal Keratitis in Dr. M. Djamil General Hospital: A Case Series
Views: 742Downloads: 643Background: Fungal keratitis is often difficult to eradicate and requires long treatment. Antifungal agents have lower efficacy because of low tissue penetration and the indolent nature of the infection. Fluconazole has effective ocular penetration ability, reaching aqueous concentration as same as plasm concentration. Multilayer amniotic membrane transplantation (MLAMT) has been shown to be a promising surgical procedure to reconstruct the ocular surface by supporting the epithelialization of the cornea and having protective antimicrobial properties. This study aims to report the outcome of concurrent intracameral fluconazole injection with amniotic membrane transplantation for fungal keratitis in Dr. M. Djamil General Hospital.
Case presentation: Four inpatients in the ophthalmology ward of Dr. M. Djamil General Hospital with moderate to severe fungal keratitis. All patients were first treated with medications. Because the patients did not show clinical improvement after getting maximum therapy, they underwent intracameral fluconazole injection concurrent with MLAMT. MLAMT was performed with multilayered amniotic membranes to fill and cover the defect. The bandage contact lens was placed to protect and keep the MLAMT in place and for patients’ comfort. Patients were then observed for signs of inflammatory reaction and epithelialization. All patients showed reduced inflammation and improved epithelization after surgery.
Conclusion: Concurrent intracameral fluconazole injection with MLAMT can be considered an alternative treatment for refractory fungal keratitis as it decreases the rate of inflammation and improves epithelization.
-
The Relationship between Sociodemography and the Level of Knowledge, Attitudes, and Behavior of Breast Cancer Patients at the Surgical Oncology Polyclinic at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Views: 583Downloads: 351Background: Breast carcinoma is the most frequently diagnosed carcinoma in the world. A person's behavior in responding to a health problem is influenced by three factors, namely predisposing factors, supporting factors, and needs factors. The predisposing factor explaining social demographics is one of the things that influence individuals to overcome health problems. This study aimed to assess the level of knowledge, attitudes, and behavior toward breast cancer in advanced breast cancer patients who seek treatment at the surgical oncology polyclinic at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
Methods: This study was an analytic observational study of 329 research subjects. The research subjects were patients at the surgical oncology polyclinic at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Observation of knowledge, attitudes, and behavior was carried out using a questionnaire adapted from the breast cancer awareness scale (BCAS-I). Data analysis was performed univariate, bivariate, and multivariate using SPSS software.
Results: Occupation (p-value 0.000 OR 3.664) has a significant relationship with the knowledge of breast cancer patients. Education and occupation have a significant relationship with the attitude of breast cancer patients. Age 35-59 years and working as a housewife have a significant relationship to the behavior of breast cancer patients.
Conclusion: There is a sociodemographic relationship with knowledge, attitudes, and behavior in breast cancer patients at the surgical oncology polyclinic at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
-
Graft Outcome of Corneal Patch for Perforated Corneal Ulcer
Views: 2,183Downloads: 594Background: Corneal patch graft (CPG) is a part of the tectonic penetrating keratoplasty procedure performed on the perforated corneal ulcer. This procedure involves filling affected areas with full or partial-thickness cornea donors. This study aimed to determine the clinical results of corneal patch grafts in perforated corneal ulcers.
Methods: A retrospective study assessing clinical results of CPG on the perforated corneal ulcer with iris prolapse. Clinical assessments include graft condition, anterior chamber depth (ACD), and visual acuity after surgery, with a follow-up duration of up to 8 weeks.
Results: Twenty-one cases of perforated corneal ulcer with iris prolapse in 15 males (71.4%) and 6 females (28.6%). Locations of ulcer are peripheral and paracentral corneal. Visual acuity showed around light perception (LP) to 0.4. The most common etiology for corneal ulcers was infection (88.9%), followed by non-infection (Mooren’s ulcer) (11.1%). The graft condition after surgery showed promising results in 18 cases (85.7%), infection in 1 case (4.8%), and melting in 2 cases (9.5%). Adequate ACD was obtained in 77.8% of cases. An increase in visual acuity was shown in 44.4% of cases, depending on the location and severity of the ulcer.
Conclusion: A corneal patch graft is an appropriate choice in treating perforated corneal ulcers to maintain ocular integrity (tectonic keratoplasty). However, in non-infectious ulcers, this procedure has not shown a good result, which may be related to disease progressivity.
-
Comparison of the Effectiveness between Povidone-Iodine and Bleomycin as Pleurodesis Agents in Patients with Malignant Pleural Effusion at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Views: 774Downloads: 391Background: Malignant pleural effusion (MPE) is a clinical problem in which fluid accumulates in the pleural cavity. This condition is generally caused by malignancy. Pleurodesis is a medical procedure in the form of fusion of the visceral and parietal pleura in order to prevent the recurrence of pleural effusion. Pleurodesis has the risk of causing chronic inflammation, which will trigger excessive attachment between the visceral and parietal pleura. Of course, an intervention is needed to reduce the risk of inflammation, one of which is by using a pleurodesis agent, which has an anti-inflammatory effect. This study aimed to compare the efficacy of povidone-iodine compared to bleomycin as a pleurodesis agent in malignant pleural effusion patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
Methods: Prospective cohort study, where as many as 46 research subjects participated in this study and were grouped into groups that received povidone-iodine and bleomycin. The success of pleurodesis agents was assessed by the production of WSD. Data analysis was carried out using SPSS univariate and bivariate.
Results: The results of the study showed that there was no statistical difference between the 10% povidone-iodine agent and the bleomycin agent, where p>0.05. However, in the 10% povidone-iodine group, the success rate was 100%, while in the bleomycin group, the success rate was 82.6%.
Conclusion: There was no significant difference in the efficacy of povidone-iodine as a pleurodesis agent compared to bleomycin in patients with malignant pleural effusion at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
