Accreditation
SINTA 2Nationally Accredited Journal
Vol. 7 No. 9 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Essential Thrombocythemia in Young Women
Views: 616Downloads: 416Background: Essential thrombocythemia (ET) is a rare disease in which there is an increase in the platelet count of more than 450,000/mm3. An increase in the number of platelets occurs due to increased proliferation of megakaryocyte series. Although there is an increase in the number of platelets in ET, it has impaired function. ET clinical manifestations in 50% of cases are asymptomatic, but in symptomatic cases can be vascular occlusive events or microvascular thrombosis.
Case presentation: A 22-year-old woman with complaints of rash on the hands and feet. Physical examination found an enlarged spleen in Schuffner 1 and ecchymosis on the arms and legs, a platelet count of 811,000/mm3. The peripheral blood smear shows large platelets, the bone marrow picture shows megakaryocytes, which are very easy to find, the size varies with sufficient platelet emission, the JAK2 gene mutation examination shows mutation detection, while the BCR-ABL gene mutation results do not detect gene fusion. Treatment is given cytoreductive therapy in the form of hydroxyurea, while acetylsalicylic acid is not given because there are contraindications for administration.
Conclusion: Essential thrombocythemia is a neoplastic proliferative disease that occurs in the megakaryocyte series. The diagnosis of ET mostly found mutations in the JAK2 gene. ET management according to risk classification, where acetylsalicylic acid can be given very low and low risk, while intermediate and high risk can be given cytoreductive therapy.
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Incidence of Anemia in Pregnant Women with Closer Spacing of Pregnancies and Multiparity: A Case Report
Views: 1,101Downloads: 1,237Background: One of the risk factors that can increase the incidence of anemia in pregnant women is the close spacing of pregnancies and multiparity. Closely spaced pregnancies refer to pregnancies that occur within a short time after the previous birth, while multiparity refers to a woman who has given birth to more than one child previously. The combination of these two factors can lead to an increased risk of anemia in pregnant women. This study presents the risk of closely spaced pregnancies and multiparity for the incidence of anemia in pregnant women. Case presentation: Mrs. SM, 27 years old pregnant woman, came with complaints of severe dizziness for the last 2 weeks. In addition, patients also complain of weakness, weakness, no energy, and no appetite. The patient said that she was currently pregnant with her 4th child, aged 27-28 weeks, with active fetal movements. Hemoglobin examination 7 mg/dL. Conclusion: The patient was diagnosed with anemia in pregnant women with risk factors for close pregnancy spacing and multiparity.
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Intensive Care Management of Eclampsia with HELLP Syndrome: A Case Report
Views: 1,527Downloads: 1,247Background: The incidence of HELLP syndrome is approximately 0.1-1% of all pregnant women and 5.5% of patients admitted to the ICU. Hemolysis, elevated liver enzymes, and thrombocytopenia are the characteristics of HELLP syndrome.
Case Presentation: A 38-year-old patient with diagnosed G4P3A0L3 31-32 weeks of preterm pregnancy + eclampsia on MgSO4 regimen, HELLP syndrome + twice previous Sectio cesarean + breech presentation. On physical examination, the general condition was blood pressure 199/103 mmHg. The results of laboratory tests post-op were hemoglobin 7,1 g/dL, leukocytes 15.930, hematocrit 24%, and platelets 38,000. The results of other laboratory tests showed decreased albumin levels (Alb 2,4), increased levels of total bilirubin 14,7, direct bilirubin 10,8 and indirect bilirubin 3,9, increased liver enzyme SGOT 2001 SGPT 513.
Conclusion: HELLP syndrome is a threatening clinical problem. Appropriate and adequate management, especially in the Intensive care unit, is needed to prevent severe complications to reduce morbidity and mortality rates in patients with HELLP syndrome.
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Relation between Chronic Rhinosinusitis and Gastroesophageal Reflux in Adults: A Systematic Review
Views: 683Downloads: 512Background: It is not entirely apparent how chronic rhinosinusitis (also known as CRS) develops. Since the 1970s, medical professionals have debated whether or not gastroesophageal reflux (GOR) could be a factor in the development of certain patients' conditions. The purpose of this research is to the relation between chronic rhinosinusitis and gastroesophageal reflux in adults.
Methods: By evaluating the preferred reporting items for systematic review and meta-analysis (PRISMA) 2020 standards, this study demonstrated that it met all of the requirements. This enabled the researchers to ensure that the study was as up to date as feasible. Publications published between 2000 and 2023 were included in the search strategy, which included a variety of electronic reference databases (including Pubmed and SagePub). We did not consider review papers, duplicate publications, or half completed articles.
Results: In the PubMed database, the results of our search brought up 133 articles, whereas the results of our search on SagePub brought up 69 articles. The results of the search conducted for the last year of 2000 yielded a total of 20 articles for PubMed and 8 articles for SagePub. In the end, we compiled a total of 21 papers, six of which came from PubMed and three of which came from SagePub. We included nine research that met the criteria.
Conclusion: According to the findings of most studies, the number of cases of CRS seen in patients with GERD is around two to three times higher than that seen in the general patient group.
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The Role of Monocyte Chemoattractant Protein-1 (MCP-1) in Diabetic Kidney Disease
Views: 970Downloads: 605Monocyte chemoattractant protein-1 plays an important role in kidney disease. In several studies, the role of MCP-1 as a urine biomarker has been extensively studied. In many kidney diseases, there are elevated levels of MCP-1 in the kidney tissue and this is an important cause of monocyte infiltration in the pathogenesis of kidney damage. Elevated urinary MCP-1 levels have been able to predict outcome in proliferative kidney diseases such as lupus nephritis. However, in several studies it was also found that there was an increase in MCP-1 in diabetic kidney disease. Macrophages have even appeared early in diabetic kidney disease and are associated with the progression of kidney disease. Urinary MCP-1 levels are related to the degree of leukocyte infiltration in the tubulointerstitial. This supports inflammatory factors as part of the pathogenesis of diabetic kidney disease.
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Intensive Management of Spontaneous Basal Ganglia Hemorrhage: A Case Report
Views: 1,281Downloads: 867Background: Simultaneous non-traumatic bilateral basal ganglia haemorrhage is an infrequent entity. ICH accounts for 10 to 20 % of all cerebrovascular events in the US, with 30-day mortality up to 40%. The predisposing factors and pathophysiological processes leading to simultaneous bilateral basal ganglia development are not well known.
Case presentation: A 43-year-old female patient was diagnosed with spontaneous intracerebral haemorrhage in the left basal ganglia and intraventricular haemorrhage. The patient underwent an urgent ICH evacuation craniotomy. After the procedure, the patient was treated in the intensive care unit. The patient was intubated for 4 days. Then, on the fifth day of stay in the ICU, a tracheostomy was performed on the patient.
Conclusion: Spontaneous ICH has high mortality and morbidity. ICH management is mainly on timely targeted blood pressure management, effective and rapid reversal of coagulopathy to prevent hematoma expansion, and uncompromising intracranial pressure management.
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The Phenomenon of Toe Walking in Children, Disease or Habit: A Case Report
Views: 865Downloads: 634Background: Some children experience abnormalities in the way they walk, such as toe walking in the form of "bilateral toeing out" or "bilateral tip toe." Bilateral toe walking, also known as “bilateral toeing out,” is a condition in which both of a child's feet tend to move outwards when they walk. On the other hand, “bilateral tip toe” is when a child walks by standing on the tips of the toes without touching heels to the floor. This study aimed to present cases of the toe walking phenomenon in children.
Case presentation: A child checks for complaints on both legs and looks at calcium and vitamin D levels. The patient came with toe walking after the age of 2 years and complained of frequent pain and soreness in both legs for the last 2 weeks. The calcium level in the blood was 5.8 mg/dL, and the vitamin D level was 10 ng/ml. At the request of the patient's parents, X-rays of both extremities were carried out, and the results were within normal limits with no masses or fractures. The patient was diagnosed with bilateral toeing out and bilateral tip toe. The treatment provided by medical rehabilitation specialist doctors to patients is in the form of medical and non-medical therapy.
Conclusion: The patient was diagnosed with bilateral toeing out and bilateral tip toe.
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Critical Care Management of Fracture Dislocation of Cervical Spine: A Case Report
Views: 687Downloads: 378Background: Spinal cord injuries affect nearly 1 million people every year, more than 90% of all cervical injuries require intubation, most cases also require tracheostomy, and nearly 40% are ventilator dependent. This study aimed to describe critical care management of fracture dislocation of spine.
Case Presentation: A 27-year-old male patient complained patient came with complaints of weakness in both limbs 13 hours before admission. Initially, the patient was driving a motorbike then the patient was involved in an accident with a car after the incident, the patient also felt a bit short of breath, could not move both his leg and hand, and could not feel defecation or urination. Patient was diagnosed with Fracture dislocation of C4-C5. The patient underwent elective decompression stabilization. Patient admitted to ICU with the majority requiring assisted ventilation. After five days in the ICU, the patient was challenged to be released from the ventilator, so the patient was performed early tracheostomy
Conclusion: Patients with cervical injuries require comprehensive care in the intensive care unit, especially in airway management and respiratory support, in addition to addressing the potentially catastrophic multisystem sequelae of nerve damage.
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Symmetric Dimethylarginine as a Biomarker for Chronic Kidney Disease
Views: 1,152Downloads: 1,324Symmetric dimethylarginine (SDMA), is a post-translationally stable catabolic product of arginine-methylated proteins that plays an important role in basic cellular metabolism. SDMA is an endogenous biomarker of kidney function that has been widely used in veterinary medicine. Symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA) are 2 constant products of L-arginine proteolysis that undergo methylation. SDMA is almost completely excreted by the kidneys after filtration making SDMA an ideal GFR biomarker candidate. Apart from that, SDMA has several advantages as a biomarker of kidney function, namely that it is not affected by non-renal factors that influence creatinine and cystatin C. Apart from that, SDMA also increases earlier than other biomarkers.
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Case Series of Rare Head and Neck Plasmacytoma: Experiences in Indonesia
Views: 548Downloads: 381Background: Solitary plasmacytoma (SP) is a rare case of plasma cell neoplasms, which only represent 5-10% of all plasma cell neoplasms that afflict two or three people per every 100,000 of the general population. This neoplasm is divided into solitary plasmacytoma of the bone (SBP) and solitary extramedullary plasmacytoma (SEP), depending on the location. Due to the rarity, SBP can be misdiagnosed as multiple myeloma (MM) while SEP as plasma cell granuloma, whereas the treatments are very different. This study aimed to present our experiences in diagnosing SP in the head and neck to differentiate them from MM and plasma cell granuloma.
Case presentation: One case of multiple solitary plasmacytomas of the bone (SPB) in the frontal bone and one case of intraoral solitary extramedullary plasmacytoma (SEP) were presented. The SBP showed abnormality in the laboratory and the CT showed a punch-out lesion which is similar to MM. The SEP showed normal laboratory findings, but the histopathology mimicked plasma cell granuloma. Both immunohistochemistry was positive for CD138, and the SEP diagnosis was confirmed by Ki67 and κ-light chain. Complete examination from history taking, physical examination, radiology and laboratory findings, bone marrow morphology, and histopathology including immunohistochemistry examination, are very important to determine the correct diagnosis.
Conclusion: the case was diagnosed as head and neck solitary plasmacytoma.
