Accreditation
SINTA 2Nationally Accredited Journal
Vol. 7 No. 12 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
-
The Relationship between Neutrophil-Lymphocyte Ratio to Intestinal Viability in Invagination Patients at Dr. M. Djamil General Hospital, Padang, Indonesia
Views: 504Downloads: 769Background: Invagination is an acute condition in the pediatric abdomen that results in obstruction and constriction of blood vessels (strangulation) in the proximal intestinal mesenterium trapped in the distal intestine, allowing necrosis of surrounding tissue. Intestinal necrosis and perforation in children are causes of abdominal emergencies that require immediate surgery. In supporting examinations, neutrophil, lymphocyte, and biomarker combination ratios have been used for early detection of systemic inflammatory markers. The threshold value of several biomarkers should be investigated to assess the occurrence of strangulation in the pre-operative period in invaginated patients. This study aimed to determine the relationship between neutrophil-lymphocyte ratio and intestinal viability in pediatric patients with invagination.
Methods: This study used retrospective analytic data collection from medical records of invagination patients at Dr. M. Djamil General Hospital Padang for the period January 1, 2020, to December 31, 2022.
Results: The majority of subjects were male (53.8%) at the age of ≤ 1 year, with as many as 87.2% having a diagnosis of operative invagination (76.9%) and 56.4% having intestinal viability. The mean neutrophil, lymphocyte, and NLR values were 62.15±17.68, 19.03±8.97, and 3.74±1.55, respectively. The pathological NLR status was found to be 59%. The p-value for the association of diagnosis with intestinal viability was 0.002. The p-value for the relationship between NLR and intestinal viability was 0.001, and the r-calculated was -0.528.
Conclusion: There is a significant relationship between NLR value and disease diagnosis on intestinal viability.
-
Factors Affecting the Mortality of Patients Undergoing Open Heart Surgery with Cardiopulmonary Bypass at Dr. M. Djamil General Hospital, Padang, Indonesia
Views: 511Downloads: 329Background: Morbidity and mortality of patients after cardiac surgery can be influenced in the preoperative, intraoperative, and postoperative periods. This study aimed to explore factors that affect the mortality of patients undergoing open heart surgery with cardiopulmonary bypass at Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: This study is an analytical observational research with a cross-sectional approach and uses secondary data obtained from the medical record installation of Dr. M. Djamil General Hospital, Padang, Indonesia. A total of 57 research subjects participated in this study. Univariate, bivariate, and multivariate analyses were carried out using SPSS software.
Results: The final multivariate modeling results show that the variables that influence patient mortality are EuroSCORE II (p-value=0.003) and duration of CPB (p-value=0.003). With an odds ratio of 37.21 groups, EuroSCORE II high risk had a risk of death 37.21 times higher than the low-risk group (CI 3.325 – 416.324). Meanwhile, increasing the duration of CPB by one minute increased the risk of mortality 1.02 times (CI 1.006 – 1.030). Meanwhile, there is no influence of variables (NYHA, LV function, ACC duration) on the incidence of mortality in patients undergoing open heart surgery with a machine cardiopulmonary bypass at Dr. M. Djamil General Hospital, Padang.
Conclusion: EuroSCORE II affects the mortality of patients undergoing open heart surgery with CPB. The duration of CPB affects the mortality of patients undergoing open heart surgery with CPB.
-
The Role of Podocyte Cells in Diabetic Nephropathy: A Narrative Literature Review
Views: 762Downloads: 909The main cells affected in diabetic nephropathy are podocytes and proximal tubular cells. One of the main functional proteins in the podocyte slit diaphragm is podocin which podocytes need to express together with several specific proteins in the correct way for their differentiation, as well as to maintain their complex anatomy. Podocytes are highly specialized epithelial cells. They line the urinary surface of the glomerular capillary bundles. Podocytes are part of the filtration barrier along with capillary endothelial cells and GBM. Podocytes ensure selective permeability of the glomerular capillary walls. Podocin is a membrane protein with a molecular weight of 42kD which is located in the foot processes, and also forms part of the SD with the nephrin protein. Urinary podocin levels more specifically indicate ongoing glomerular damage because they were significantly increased in the normoalbuminuria group compared with the control group.
-
Reperfusion Arrhythmia in Acute Myocardial Infarction
Views: 1,536Downloads: 462Management of reperfusion in acute myocardial infarction is an important component of myocardial cell survival to minimize the area experiencing infarction and improve patient clinical outcomes. However, this reperfusion also contributes to myocardial injury which is preceded by the ischemic process. One of the injuries related to the ischemia-reperfusion process in the myocardium is reperfusion arrhythmia. Reperfusion arrhythmias from several studies can begin to occur in the first minutes after restoration of obstructed coronary flow. The features of reperfusion arrhythmia can include accelerated idioventricular rhythm, ventricular tachycardia, ventricular fibrillation, and other arrhythmias. The mechanism of reperfusion arrhythmia can be excess calcium in the cells, oxidative stress due to an increase reactive oxygen species, energy metabolism disorders, and neutrophil accumulation. Excessive intracellular calcium and other mechanisms cause a delay in the depolarization of previously ischemic cells. This reperfusion arrhythmia requires special attention because it can disrupt hemodynamics and patient outcomes after reperfusion procedures. Knowledge of the mechanisms of reperfusion arrhythmias will guide clinicians to provide better management during and after reperfusion procedures.
-
Supraclavicular Brachial Plexus Block Guided by Ultrasonography in Pediatric Patient: A Case Report
Views: 655Downloads: 609Background: Supraclavicular brachial plexus block has proven to be very useful in upper limb surgeries in pediatric patients. Supraclavicular brachial plexus block is preferred over general anesthesia for pediatric patients undergoing upper limb surgeries. This study aimed to report a procedure of supraclavicular brachial plexus block guided by ultrasonography in a pediatric patient undergoing orthopedic surgery on the upper extremity, which yielded good results, a high success rate, reduced opioid usage, and aided in faster recovery while minimizing complications.
Case presentation: The patient was a 14-year-old child with a diagnosis of malunion in the left distal radius after open reduction internal fixation (ORIF) planned for osteoclasis surgery and ORIF with regional anesthesia through supraclavicular brachial plexus block. The patient was monitored during the surgery, and after the surgery, the patient returned to the ward; the patient was given oral analgesics without opioids for pain management.
Conclusion: The efficient regional anesthesia procedure option for upper limb surgeries in pediatric patients is the supraclavicular brachial plexus block. Due to lower risks and fewer side effects, the supraclavicular brachial plexus block procedure is preferred over general anesthesia in pediatric patients.
-
Oral Vitamin D Supplementation as Add-On Therapy in Adult Patients with Atopic Dermatitis
Views: 649Downloads: 547Background: Recent studies have highlighted the possible role of vitamin D in atopic dermatitis (AD) so that it can be used as therapeutical of AD. The aim of study to evaluate the effect of vitamin D supplementation as add-on therapy in adult patients with AD.
Methods: Twenty-four adult patients with AD were included in a randomized, double-blind, placebo-controlled trial study. This study was conducted in Dr. Moewardi General Hospital Surakarta, Indonesia, from February to March 2023. Subjects were randomly assigned to oral cholecalciferol 5,000 IU/day versus placebo for 4 weeks and all subjects were given emollient. The severity of AD was evaluated by using scoring of atopic dermatitis (SCORAD) before and after the trial.
Results: Compared to placebo, vitamin D supplementation for 1 month obtained clinically and statistically improvement in SCORAD score compare to control (-4.508 : 4.500, p= 0.000). Moreover, vitamin D supplementation had strong negative correlation to SCORAD score after the trial (r= -0.780, p= 0,000). There were no adverse effects in either group. and
Conclusion: Clinical improvement was achieved after vitamin D supplementation as add-on therapy in adult patients with AD.
-
Continuous Sciatic Popliteal Block as Postoperative Pain Management in Patient with Closed Fracture Right Ankle Undergo ORIF PS Surgery
Views: 584Downloads: 491Introduction: Currently, foot and ankle surgeries are on the rise, and a significant challenge in these cases is the intense post-operative pain that arises from early patient mobilization. Continuous popliteal sciatic block have emerged as a solution, effectively alleviating pain from the intra-operative to post-operative stages for patients undergoing foot and ankle surgery. According to a study conducted by Ding and colleagues, continuous blocks have proven to be more effective than a single injection in providing pain relief.
Case presentation: A 24-year-old woman diagnosed with a closed fracture of her right ankle is scheduled for open reduction internal fixation (ORIF) with a plate and screws for her right ankle. The patient has an American Society of Anesthesiologists (ASA) physical status of III and is dealing with grade II obesity. A continuous popliteal sciatic block was performed on the patient under ultrasound guidance, with the catheter tip placed outside the perineural area. Postoperatively, the patient received pain management through a regimen of 0.1% bupivacaine, 20 ml volume, administered every 4 hours. Remarkably, the patient experienced minimal pain until the 2nd day after surgery and was discharged home.
Conclusion: The continuous popliteal sciatic block is a regional anesthetic method that offers potent pain relief for patients undergoing foot and ankle surgery. Extensive evidence supports its effectiveness and safety during administration, making it a reliable choice for pain management in these procedures.
-
Management for Patient with Asthma in Lumbal Canal Stenosis Using General Anesthetic and Epidural Analgetic: A Case Report
Views: 1,810Downloads: 321Background: Lumbar canal stenosis, which often occurs concurrently with degenerative spondylolisthesis (DS), is characterized by low back and leg pain. The treatment of high-degree spondylolisthesis is by surgery, which is a combination procedure of decompression and fusion. Surgical patients with a history of uncontrolled asthma three months before surgery had nearly double the risk of postoperative mortality. Case presentation: A 53-year-old male patient was diagnosed with Lumbal Canal Stenosis ec HNP at levels L2-l3, L3-l4, L4-l5, L5-s1 Spondylolisthesis at level L4-l5 Meyerding grade 1 Spondylosis Lumbalis. The patient has a history of mild intermittent bronchial asthma, which was diagnosed 2 years ago. The patient was planned for Decompression-Stabilization-Fusion surgery, with the anesthesia plan being general anesthesia prone position with epidural analgesia. Conclusion: Combined general anesthesia (GA) and epidural analgesia (EA) for major surgery due to excellent pain control, reduced perioperative morbidity, and even reduced mortality compared with systemic analgesia. For surgical patients who have a history of asthma, determining whether a patient's asthma is well-controlled or poorly controlled is key to mitigating perioperative complications.
-
Opioid-Free Anesthesia (OFA) as a Safe Anesthetic Choice for Epilepsy Patient
Views: 482Downloads: 317Background: The opioid-free anesthesia (OFA) approach, although not widely employed in anesthesia, offers distinct benefits for some populations, such as epilepsy patients, due to the propensity of opioids to trigger seizures. Hence, the objective of this study was to conduct an opioid-free anesthesia (OFA) procedure on the left lateral rhinotomy in a patient with concurrent epilepsy.
Case presentation: Our patient is a 59-year-old woman suffering from epilepsy with a left nasal cavity tumor, scheduled for a left midfacial degloving rhinotomy. Given the patient's epilepsy comorbid, we have opted for an opioid-free anesthesia (OFA) procedure. OFA procedures are not yet widely employed in anesthesia; however, they offer advantages for specific patient populations, including epilepsy patients, as opioids have the potential to induce seizures.
Conclusion: The various OFA protocols being conducted worldwide require refinement, and the potential interactions of each component should be explored further.
-
Differences in Facial Skin Acidity Levels of Nurses in Sebelas Maret University Hospital, Before and After Surgical Mask Use During the COVID-19 Pandemic
Views: 446Downloads: 281Background: Indonesia has reported more than 4 million confirmed COVID-19 cases as of November 2021. This has led to an increase in the use of personal protective equipment (PPE), for example, surgical masks in hospitals, especially referral hospitals for COVID-19 patients. The Potential Hydrogen (pH) or level of acidity plays an important role in the body's physiological functions and regulates the formation of an epidermal barrier (stratum corneum). Thus, the use of surgical masks is able to influence the pH of human skin. This study aimed to determine the difference in facial skin acidity (pH) levels of nurses at Sebelas Maret University Hospital before and after surgical mask use.
Methods: The study utilized a cross-sectional observational method and was conducted at the Sebelas Maret University Hospital, Surakarta. A total of 55 subjects were involved in this study, and each subject’s facial skin Potential Hydrogen (pH) was measured before and after surgical mask use. Subsequently, all data were analyzed with a T-test using SPSS 21.00, and a p-value <0.05 indicated statistical significance.
Results: The results showed facial skin pH increased after surgical mask use for nurses at the Sebelas Maret University Hospital (p = 0.000).
Conclusion: An increase in the physiological value of skin pH was observed in the nurses of Sebelas Maret University Hospital after surgical mask use.
-
Anesthesia Management in Morbidly Obese Patient Undergoing Neurosurgical Procedure: A Case Report
Views: 531Downloads: 577Background: Anesthesia management in morbidly obese patients undergoing any neurosurgical procedure is particularly challenging. This case report aims to further discuss the importances and concerns regarding the anesthesia management of decompression craniectomy in morbidly obese patients.
Case presentation: A 46-years-old male patient was diagnosed with intracerebral hemorrhage on regio left external capsule due to hypertensive emergency suspected from Middle Cerebral Artery (MCA) aneurysma rupture. Decompression craniectomy with clot evacuation was planned. This patient has morbid obesity. Prediction of difficult intubation and mask ventilation can be assessed using LEMONS, MOANS, Mallampati score and STOP-Bang Questionnaire. The dosage of anesthetic agents used in these patients had been adjusted according to current recommendations. Intraoperatively, patient’s hemodynamic was successfully maintained stable. Postoperatively, patient was closely monitored in the intensive care unit.
Conclusion: It is imperative to acquire adequate knowledge on choosing the effective anesthetic management during the preoperative, intraoperative, and postoperative periods to achieve good outcome in morbidly obese patient undergoing neurosurgical procedures.
-
Vitamin D Levels in Epilepsy Patients at the Neurology Polyclinic, Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Views: 560Downloads: 447Background: In epilepsy patients, treatment is often lifelong and anti-epileptic drugs (AEDs) can be divided into two general groups, namely drugs that affect cytochrome P-450 (CYP-450) such as carbamazepine, phenytoin, primidone, or valproic acid, and those that affect minimal cytochrome P-450 such as gabapentin, vigabatrin, levetiracetam, oxcarbazepine, or topiramate. AEDs include various drugs that can cause a decrease in vitamin D levels. Therefore, this study was aimed at examining vitamin D levels in epilepsy patients who took AEDs at the neurology polyclinic at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
Methods: This research is a descriptive study with a cross-sectional design using primary data obtained from the results of patient examinations using laboratory tests and secondary data from medical records.
Results: As many as 78% (14 subjects) who received monotherapy had vitamin D levels below normal, and 16 subjects, or 76%, who received polytherapy had vitamin D levels below normal (p = 0.907). A total of 13 (72%) subjects who received phenytoin had vitamin D levels below normal, as well as 5 (63%) subjects who received carbamazepine and 12 (92%) subjects who received other therapies (p = 0.235). A total of 12 (67%) subjects who received therapy for 1-3 years and 18 (86%) subjects who received therapy > 3 years had vitamin D levels below normal (p = 0,406).
Conclusion: Vitamin D deficiency is a crucial problem in epilepsy patients receiving AED therapy, where more than 75% of patients have vitamin D deficiency. In this study, vitamin D deficiency did not have a significant relationship with the type of therapy (monotherapy or polytherapy) or the type of drug used. used, duration of therapy, and frequency of sun exposure.
