Accreditation
SINTA 2Nationally Accredited Journal
Vol. 8 No. 1 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Diagnosis and Management of Osteosarcopenia
Views: 949Downloads: 560Osteosarcopenia is a syndrome defined as a combination of low bone density and muscle mass as well as decreased strength and/or functional capacity. Osteoporosis and sarcopenia often coexist in the elderly, leading to a significantly worse prognosis. The epidemiology of osteosarcopenia is quite limited because the term is still new. Osteosarcopenia is more common in women than men and in malnutrition. Age-related immunological changes such as hormonal imbalance, chronic inflammation, increased oxidative stress, imbalance in protein metabolism, increased fat deposition, decreased physical activity, and poor nutritional status contribute to sarcopenia. Decreased bone density in osteoporosis can occur due to an imbalance between osteoblasts and osteoclasts. The diagnosis of osteosarcopenia is made based on the presence of osteoporosis and sarcopenia. Instrument strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC–F) are recommended for assessing sarcopenia and the fracture risk assessment tool (FRAX) for the risk of osteoporotic fracture. Management of osteosarcopenia is carried out holistically, including management of osteoporosis and sarcopenia both non-pharmacologically and pharmacologically.
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Effect of Extraction Method and Solvent Type on Total Phenolics Content, Total Flavonoid and Antioxidant Activity of Pegagan Extract (Centella asiatica (Linn.) Urban)
Views: 1,484Downloads: 1,344Background: Centella asiatica (CA) or pegagan or horse foot leaves is one of the traditional plants widely used to treat various diseases. This study aims to evaluated the content of total phenolics and total flavonoids, as well as the antioxidant activity of Centella asiatica extracts from different methods and solvents.
Methods: The sample was divided into three groups, (70% ethanol maceration, methanol maceration and water infundation). Total phenolic compounds in the extract were determined by the Follin-Ciocalteu method, total flavonoid content was determined by the aluminum chloride colorimetric assay method, and antioxidant activity was assessed by the immersion DPPH free radicals method. Determination data of IC50 was assessed by regression test and differences between the three extract groups were tested by ANOVA or Kruskal Wallis test.
Results: The highest total phenolics and total flavonoid were obtained in Centella asiatica extract with water solvent, 251.88 ± 0.96 mg/g GAE and 7.26 ± 0.03 mg/g QE, followed by 70% ethanol and methanol. In addition, the best antioxidant activity was also shown in the extract with water, namely 24.09 ± 0.01. The difference test results between all groups showed significant results (p<0.05) in all parameters.
Conclusion: The best content of total phenolic, total flavonoid, and antioxidant activity was obtained by infundation with water solvent. In the maceration method, the best content of the three parameters measured was obtained in the group with ethanol solvent.
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The Effect of Giving Human Umbilical Cord Mesenchymal Stem Cells (HUMSC) on the Expression of Collagen I in Menopause Model Mice
Views: 584Downloads: 343Background: Patients with pelvic floor dysfunction (PFD) who fail conservative treatment will undergo surgery. In recent years, various therapeutic approaches for PFD using stem cells have been investigated in vivo. One component of stem cells is the human umbilical cord mesenchymal stem cell (HUMSC). It is hoped that HUMSC can modify the collagen and elastin content in the extracellular matrix, leading to improvements in pelvic floor strength and PFD.
Methods: This research is an experimental study with a randomized posttest-only controlled group design with the aim of determining the effect of giving HUMSC on the expression of Collagen I in a female mouse model of menopause. There are inclusion criteria, namely female Balb/c mice, healthy, never mated, aged 8 - 12 weeks, and body weight 18 - 22 grams. The research will be carried out with statistical analysis using SPSS; a p-value <0.05 is considered significant.
Results: The results of the analysis of the distribution of sample means show that there are significant differences between the two groups. The treatment group had a higher mean expression of type I collagen compared to the control group. In addition, variation in the control group was lower compared with the treatment group, which could be interpreted as higher consistency in the response to HUMSC treatment.
Conclusion: Human umbilical cord (HUMSC) has a positive impact on type I collagen expression in menopausal model mice.
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Combined General Anesthesia with Epidural Analgesia as a Modality for Adrenal Teratoma Resection in Patients with Coronary Arterial Disease
Views: 595Downloads: 366Background: Adrenalectomy in patients with coronary arterial disease poses a significant challenge requiring good preoperative evaluation, perioperative hemodynamic control, and a detailed and careful anesthetic strategy. Teratomas are benign tumors that develop from pluripotent cells with two or more germ cell layers. Teratomas can develop in the ovaries and testes. Retroperitoneal teratoma, particularly adrenal teratoma, is rare. Indications for adrenal gland surgery include hormonal secretory tumors and non-hormonal secretory tumors.
Case presentation: A 66-year-old man complained of discomfort in the right upper abdomen. From the results of the CT scan, an adrenal teratoma was obtained, and an adrenalectomy operation was planned. The patient underwent adrenalectomy with general anesthesia. Induction was carried out with propofol titrating doses of 100-150 mg until the patient was hypnotized and intubated with Atracurium 30 mg IV. The patient underwent an arterial line and CVC with ultrasound guiding during surgery.
Conclusion: Anesthetic techniques should aim to maintain a myocardial oxygen supply that is greater than required to avoid ischemia. It is necessary to control perioperative hypertension, hyperglycemia, hypokalemia, and blood cortisol levels and maintain the balance of myocardial oxygen supply.
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Risk Factors Affecting Length of Stay in Preterm Infants at Wangaya Regional General Hospital, Indonesia
Views: 837Downloads: 511Background: Advances in neonatology have led to many preterm infants being saved. Prolonged length of stay (LOS) increases the incidence of neonatal complications and even mortality, placing a significant economic burden on families and strain on healthcare systems. This study aims to determine the factors associated with LOS in preterm infants.
Methods: This cross-sectional study involved 60 preterm babies treated at Wangaya Hospital from May 2022 to May 2023. Infants with congenital anomalies, referred from other hospitals and did not receive appropriate treatment were excluded from the study. Data were taken from the electronic medical record after obtaining ethical clearance and then analyzed using descriptive statistics and linear regression in SPSS 25. Statistical significance was considered at 0.05.
Results: As many as 46 out of 60 preterm infants were born at moderate to late preterm gestational age. The majority of 81.7% of infants were born with a body weight of 1500-2499 grams. The median number of LOS was 7.5 days (IQR 15). Multivariate analysis of numerical independent variables obtained an equation log [LOS] = 2.902-0.066*gestational age+ 0.022*duration of parenteral nutrition (R2 = 78.1%). Meanwhile, in the categorical independent variables obtained, an equation log [LOS] = 0.398 + 0.223*very preterm + 0.144* RDS + 0.178*NEC + 0.206*prolonged antibiotics administration + 0.278*late enteral feeding + 0.148*abdominal distension + 0.144*vomiting (R2 = 87.4%).
Conclusion: Factors influencing LOS of preterm infants are gestational age, duration of parenteral nutrition, the presence of RDS, NEC, vomiting, abdominal distension, late enteral feeding, and prolonged use of antibiotics. It is essential to carry out antenatal care for pregnant women to prevent premature birth.
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Management of Anesthesia in Patient with Osteogenesis Imperfecta Type IV and Fractures on Tibia and Fibula: A Case Report
Views: 580Downloads: 479Background: Osteogenesis imperfecta (OI), known as brittle bone disease, is a rare inherited and genetic skeletal disorder characterized by a significantly heightened risk of fragility fractures. About 1 in 15 to 20.000 births are affected with OI. these defects may moreover be combined with an airway that's troublesome to oversee, platelet dysfunctions, and other issues. The perioperative administration of anesthesia speaks to a significant challenge. Subsequently, it is critical to be able to anticipate the dangers during the perioperative period and to define and actualize particular high-quality anesthesia administration plans for such patients when they involve injury.
Case presentation: We present a case of a female patient 26 years old with known OI type IV who underwent Osteotomy and Open Reduction Internal Fixation with plate and screw (ORIF PS) on her left Tibia and Fibula. In this case, we present the anesthesia technique with general anesthesia using a metal wire-enforced endotracheal tube to prevent partial obstruction due to kyphoscoliosis.
Conclusion: It is crucial to assess the severity of the disease, identify risk factors in advance, and optimize the preoperative health status of individuals with OI.
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A 63-Year-Old Man with Neurofibromatosis Type 1 and Intracerebral Astrocytoma: A Case Report
Views: 485Downloads: 296Background: Neurofibromatosis type 1 (NF-1) is one of the hereditary neurocutaneous disorders. Neurofibromatosis type 1 has broad clinical manifestations that can occur in the skin, bones, eyes, and nervous system. In progressive cases, NF-1 can malign and cause intracerebral tumor lesions. Astrocytoma, especially pilocytic astrocytoma, is one of the tumor classes that patients with NF-1 can develop with far-reaching disease progression. This case report presents a case of NF-1 with intracerebral astrocytoma.
Case presentation: A 63-year-old man with whole body lumps since childhood presented with weakness in the right limbs 1 month ago. 3 months earlier, the patient also had a full-body seizure for 1 minute twice. The patient then underwent a magnetic resonance imaging (MRI) examination of the brain and found a mass in the left centrum semiovale, left corona radiata, left insular, left external capsule, and left frontotemporoparietal lobe with a size of 7.2 x 5.3 x 6.2 cm. The patient then underwent a VP shunt followed by tumor resection. The tumor was successfully evacuated, and histopathological examination with hematoxylin & eosin (HE) staining revealed glioblastoma multiformis. The patient also underwent histopathologic examination with Ki-67 immunohistochemistry (IHC) staining and showed pilocytic astrocytoma.
Conclusion: Craniotomy of tumor excision is the definitive therapy in neurofibromatosis patients accompanied by intracerebral astrocytoma.
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Cochlear Implantation with Fontan Circulation: A Rare Case of Non-Cardiac Pediatric Surgery
Views: 556Downloads: 78Background: Fontan circulation is a cardiac circulation following the Fontan procedure in patients with a single ventricle congenital heart defect. This circulation depends on the difference in pressure between pulmonary capillaries and central venous pressure to achieve optimal cardiac output. This case report aims to discuss intraoperative anesthesia management in a patient with Fontan circulation undergoing a non-cardiac surgical operation.
Case presentation: The patient is a 7-year-old male with a history of congenital heart disease who has undergone the Fontan circulation procedure and is now undergoing Cochlear implantation surgery. The patient was managed with general anesthesia - endotracheal intubation and controlled ventilation during the operation, following the principle of minimizing intrathoracic positive pressure, low PEEP, and low tidal volume with a target peripheral saturation > 95%. Cardiac output monitoring during the intraoperative period is done using intra-arterial blood pressure. After 5 hours of surgery, the patient was extubated with stable hemodynamics.
Conclusion: The primary goal of intraoperative anesthesia management in patients with Fontan circulation is to maintain an optimal transpulmonary gradient by ensuring optimal transpulmonary blood flow, thus preserving cardiac output.
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Correlation of Platelet-Derived Growth Factor-BB Levels as a Biomarker of Liver Fibrosis with the Degree of Fibrosis Based on Fibroscan in Chronic Hepatitis B Patients
Views: 623Downloads: 341Background: Liver fibrosis is scar tissue that forms due to excessive accumulation of ECM proteins due to chronic liver injury, mediated by cytokines involving complex cellular interactions, such as platelet-derived growth factor-BB (PDGF-BB). In Indonesia, no research has been conducted to determine the correlation between PDGF-BB levels and the degree of liver fibrosis based on fibroscan. The aim of this study is to assess the correlation between PGDF-BB levels and the degree of liver fibrosis based on fibroscan in chronic hepatitis B.
Methods: A cross-sectional study was conducted on the chronic hepatitis B population at the internal medicine clinic of Dr. Mohammad Hoesin General Hospital Palembang from January to Agustus 2023. The assessment uses fibroscan to determine the degree of liver fibrosis, measured in kilopascals (kPa). PDGF-BB levels measured by ELISA.
Results: From 40 subjects, the majority of chronic hepatitis B patients were women (57,5%). The lowest PDGF-BB level was found in chronic hepatitis B patients with fibroscan F0, and the highest PDGF-BB level in fibroscan F4. Fibroscan results are directly proportional to PDGF-BB level.
Conclusion: PDGF-BB has a strong positive correlation with the degree of fibroscan in chronic hepatitis B patients in Dr. Mohammad Hoesin General Hospital. The higher the range of PDGF-BB levels, the higher the degree of fibroscan in chronic hepatitis B patients.
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Management of Extensive Subcutaneous Emphysema with Blow Hole Infraclavicular Incision and Continuous Suction Installation
Views: 1,062Downloads: 713Background: Subcutaneous emphysema often occurs in cases of implanted pneumothorax chest tubes and must always be evaluated. Subcutaneous emphysema is a condition where air or gas is found in the tissue under the skin.
Case presentation: A 49-year-old man was treated for sudden shortness of breath that occurred after a violent cough accompanied by pain and heaviness in the chest area 1 day before admission to the hospital. The patient had previously received anti-tuberculosis drug treatment for 6 months based on chest X-ray results in 2022, and the patient had undergone a rapid molecular test (TCM) examination, mycobacterium tuberculosis (Mtb), and obtained Mtb results not detected. Lung auscultation obtains sound intensity breath weakness until it disappears in both lung fields. Palpation of the skin revealed widespread crepitus on the face, neck, upper extremities, back, chest, and abdomen. The range of motion areas of the neck, shoulders, and hands are limited due to pain with movement. Evaluation of the chest tube obtained: the chest tube was installed in the anterior axillary line on the right at the level of the 5th intercostal space with number 10 attached to the chest wall and the chest tube well fixed to the chest wall. The end chest tube has been connected to the WSD bottle, and evaluation of the WSD shows that there are undulations and bubbles.
Conclusion: The patient was admitted with spontaneous pneumothorax secondary to tuberculosis and was implanted with a chest tube.
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The Effects of Vitamin E Administration in Non-Alcoholic Fatty Liver Disease
Views: 3,089Downloads: 549Non-alcoholic fatty liver disease (NAFLD) is a liver disease which has high prevalence in the society. There is no drug that is considered to be able to effectively treat this disease until today. The treatments has wide range from modifications to diet and exercise. The role of vitamin E in the treatment of NAFLD has been studied in many researches. It has high antioxidant capacity that have the ability to decrease the level of reactive oxygen species (ROS) and prevent oxidative damage that can cause cellular senescence and apoptosis. The antioxidant properties may inhibit the progression into liver damage and may even treat hepatic fibrosis in NAFLD. It also has an anti-inflammatory role that affects various inflammatory cytokines produced in NAFLD. The use of vitamin E in non-alcoholic steatohepatitis without diabetes is advised by recent guidelines from the American Association for Study of Liver Disease (AASLD) and the European Association for the Study of Liver Disease (EASLD). In patients with non-alcoholic steatohepatitis, vitamin E can decrease oxidative stress, inhibit the pathogenesis of the disease, and be used as a therapeutic option. However, new research on the safety and efficacy of vitamin E in treating diabetic non-alcoholic steatohepatitis patients is still deemed insufficient.
