Accreditation
SINTA 2Nationally Accredited Journal
Vol. 8 No. 3 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Thoracic Ultrasound: A Narrative Literature Review
Views: 875Downloads: 923Ultrasonography (USG) is useful in diagnosing abnormalities in the thoracic area, such as pleural effusion, pneumothorax, consolidation, atelectasis, pulmonary edema, etc. The advantages of thoracic ultrasound are low cost, non-radiation, non-invasive, easy to carry, short examination time, and a dynamic aspect that can be seen during the examination. Thoracic ultrasound can be used to guide thoracentesis procedures, chest tube placement, and aspiration of lung abscesses. Ultrasound can be substituted as a computed tomography scan (CT-Scan) as a guide for aspiration and biopsy of the lung parenchyma, pleura, and chest wall. Portable and compact ultrasonography provides the opportunity for ultrasound examinations to become a routine part of an examination, like a stethoscope. Ultrasonography also has limitations in patients with subcutaneous emphysema, peripheral edema, and obesity. Ultrasound examination is very dependent on the experience and abilities of the operator.
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Antibiotic Management in Bacterial Pneumonia: A Narrative Literature Review
Views: 920Downloads: 849Pneumonia is an acute inflammation of the lung parenchyma caused by various types of microorganisms, such as bacteria, viruses, fungi, and parasites. The use of antibiotics is often faced with many types and inappropriate doses, and using antibiotics for too long can increase the risk of bacteria multidrug resistance (MDR). Therefore, the choice and dosage of antibiotics must be appropriate to reduce the rate of bacterial resistance. The increasing incidence of bacterial resistance is an indicator of failure in treating pneumonia because, apart from clinical improvement, optimal eradication of bacteria should also be the goal in every antibiotic administration. The aim of this literature review is to explain the basis for administering and selecting empiric antibiotics for pneumonia infections as well as appropriate antibiotic management and adequate especially in bacterial pneumonia, to provide a better prognosis.
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Aspergillosis in Lung Cancer: A Narrative Literature Review
Views: 620Downloads: 627Aspergillosis is one of the complications of lung cancer and lung cancer treatment. Diagnosis of Aspergillosis in lung cancer, in general, is still a challenge because clinical symptoms and examination results are not typical, and risk factors often go unnoticed. To simplify the diagnosis of Aspergillosis, several criteria have been created based on the patient's condition, clinical and radiological features, and mycological laboratory examination. Doctors' vigilance still needs to be increased, examination facilities are still limited in certain cities, and diagnostic services have not been integrated, so management is not optimal. This literature review aims to increase doctors' knowledge and awareness regarding aspergillosis in lung cancer, which is an important step to improve the appropriate management of this disease.
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Strangulated Incisional Hernia Post Appendectomy: A Rare Case Report
Views: 1,140Downloads: 548Background: Incisional hernia is a condition in which internal organs, such as the intestines, protrude through a previous surgical incision or suture. This occurs due to the failure of the abdominal wall to close properly. The closure of the abdominal wall is influenced by patient-related factors and technical factors during surgery. Incisional hernia following appendectomy is a rare condition, with an incidence rate of less than 0.12%. With this case report, the author aims to contribute to the literature on strangulated incisional hernia post-appendectomy.
Case presentation: A 42-year-old male presented to the emergency department with complaints of right lower abdominal pain for the past three days. The patient reported a lump that had been intermittently present for the past nine years but became persistent three days ago. The patient had a history of appendectomy nine years ago. Vital signs were relatively stable, and physical examination revealed a bluish mass measuring 10x8x4 cm in the abdomen. Radiological abdominal assessment revealed a high-level obstructive ileus. Subsequently, the patient underwent a laparotomy, and a right hemicolectomy was performed, removing a segment measuring 50 cm from the ileocecal junction to the ascending colon.
Conclusion: Incisional hernia following appendectomy is a rare complication, but it can occur due to various risk factors, such as surgical site infection, improper choice of suture material, and inappropriate wound closure technique. The management of this condition can involve the use of tension-free synthetic mesh in either laparotomy or laparoscopy.
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Postoperative Craniopharyngioma in a 10-Year-Old Girl Presenting with Central Precocious Puberty, Central Diabetes Insipidus, and Growth Hormone Deficiency
Views: 661Downloads: 406Background: Hypopituitarism is the most common endocrinology complication of postoperative craniopharyngioma. However, we found a 10-year-old girl with a history of postoperative craniopharyngioma presenting with central precocious puberty (CPP), central diabetes insipidus (CDI), and growth hormone deficiency (GHD).
Case presentation: A 5-year-old girl experienced breast growth followed by menstruation six months later. The patient's weight was 19 kg (weight-for-age: P25-P50), height was 109 cm (height-for-age: P10-P25), and good nutritional status (Waterlow 90%). The stage of pubertal development was M2P2. There was a history of craniopharyngioma, and it was resected at the age of 2 years. After surgery, the patient developed CDI and has received desmopressin. No new tumour growth was found from evaluation with periodic MRIs every three years. After CPP was established, with increased serum levels of LH, FSH, and estradiol, GnRH agonist therapy was given at 100 mcg/kg BW every month. During five years of follow-up, the patient experienced clinical and laboratory improvement. However, the growth is only 3-4 cm/year (<P3) with short stature (height-for-age: <P3) and overweight. Low levels of IGF1 and GH were found in the stimulation test results, so the diagnosis of GHD was confirmed. The patient will receive growth hormone therapy and is expected to reach her potential genetic height (148.5 - 165.5 cm).
Conclusion: Even though the craniopharyngioma tumour has been resected and no recurrence has occurred, it is crucial to evaluate the hormones produced by the pituitary thoroughly.
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Difficult Airway Management of Reconstructive Surgery for Noma (Cancrum oris): A Rare Neglected Disease
Views: 768Downloads: 465Background: Noma is a rare necrotizing gangrenous stomatitis that occurs due to poor oral hygiene and chronic malnutrition. Noma’s survivors usually had significant facial deformities that needed reconstructive surgery as its definitive treatment. However, this facial deformity can result in a difficult airway that is very challenging for anesthesiologists.
Case presentation: A 22-year-old male patient had a significant deformity on his left face due to Noma. Preoperative evaluation revealed a potentially difficult airway due to deformity of the maxilla and mandible, malocclusion, inadequate mask seal, and incomplete dentition. Nasal fiberoptic intubation was chosen as the management of a difficult airway in this patient. A tracheostomy was prepared as the emergency invasive airway in the event of failed intubation attempts. Intubation attempts were limited to three times, and the nasal fiberoptic intubation in this patient was successful on the third attempt. The patient was stable, and the airway was safely maintained during the surgery.
Conclusion: Detailed and careful perioperative evaluation had vital role assessing potential difficult airway and planning the optimal airway management for patient with facial deformity. Nasal fiberoptic intubation is still the safest choice with high success rate for Noma patient with significant facial deformity.
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The Relationship between COVID-19 Vaccination and the Severity of COVID-19 in Patients Treated for the Period August 2021 – August 2022 at Arifin Achmad General Hospital, Riau Province, Indonesia
Views: 559Downloads: 306Background: The use of the COVID-19 vaccine is very effective in controlling the pandemic, but it is important to know that no vaccine is 100% effective in preventing the COVID-19 pandemic. Vaccination can make the disease milder so that the risk of infection, hospitalization, and death is lower in people who have been vaccinated compared to those who have not been vaccinated. This study aims to determine the relationship between COVID-19 vaccination and the severity of COVID-19 infection in patients treated at Arifin Achmad General Hospital, Riau Province, for the period August 2021 to August 2022.
Methods: This study is an analytical observational research with a cross-sectional approach. A total of 403 research subjects were included in this study. Data analysis using Chi-square by looking for the relationship between the dependent variable and the independent variable. Ineligible bivariate data will be performed using the Fisher test with a p-value < 0.05 considered significant based on statistical tests.
Results: The percentage of mild and moderate severity patients was generally the highest in the group who did not receive vaccination, with the percentage being 45.8%, followed by those who received booster (30.4%). Of the 54 cases of patients with severe-critical severity, 27 cases were dominated by patients who had no vaccination status at all, with a percentage of 50.0%. Subjects who did not receive vaccination had a 3.37 times higher chance of developing severe COVID-19 than those who were vaccinated (odds ratio = 3,37; 95% confidence interval [THERE] = 1,95-4,80).
Conclusion: The relationship between COVID-19 vaccination and the severity of COVID-19 infection in patients treated at Arifin Achmad General Hospital, Riau Province, for the period August 2021 to August 2022.
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The Jarisch-Herxheimer Reaction on Secondary Syphilis Patient with Roseola Syphilitica and Human Immunodeficiency Virus Co-Infection: A Case Report
Views: 1,455Downloads: 1,720Background: The Jarisch-Herxheimer reaction is an inflammatory reaction that occurs within 12 hours after administration of antibiotic therapy for spirochaeta species like Treponema pallidum. The reaction includes fever, headache, reappearing or worsening of skin lesions, lymphadenopathy, pharyngitis, malaise, and myalgias.
Case presentation: We present a 27-year-old man complaining of high fever 4 hours after the injection of benzathine penicillin. The patient also complained of headaches, body aches and aches. There were no complaints of shortness of breath, itching, skin blisters, red eyes, or sores on the genitals. History of take any medication was denial by the patient. After treatment by giving antipyretics and corticosteroids and getting enough rest, in the 24 hours, the patient was improved.
Conclusion: The Jarisch-Herxheimer reaction is an inflammatory reaction that occurs after the administration of antibiotic therapy for spirochaeta species like Treponema pallidum.
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Peripartum Cardiomyopathy: A Case Report
Views: 657Downloads: 513Background: Peripartum cardiomyopathy (PPCM) is a type of dilated cardiomyopathy of unknown origin. Predisposing factors for PPCM are multiparity, family history, ethnicity, smoking, diabetes, hypertension, preeclampsia, malnutrition, and advanced age in pregnant women or teenage pregnancy.
Case presentation: A 29-year-old female patient was treated in the internal medicine department of Dr. M. Djamil General Hospital Padang on March 18th, 2023, with the main complaint of shortness of breath. On physical examination, signs of congestion were found. ECG shows sinus tachycardia, QT prolongation, and T inversion in V3-V6, II, III, and aVF. The patient is established with peripartum cardiomyopathy, community-acquired pneumonia, nonsevere low-risk MDR, hypochromic microcytic mild anemia et causa chronic disease, high-risk VTE, h hypokalemia et causa diuretic.
Conclusion: Education regarding recurrent recurrence of PPCM in subsequent pregnancies is 30-50%. The prognosis depends on the recovery of left ventricular function; 30% of patients can return to baseline ventricular function within 6 months, and 50% of patients have an improvement in symptoms and ventricular function. Contraception is recommended that does not pose a risk of thromboembolism, such as a uterine device (IUD) and subcutaneous progesterone.
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Bronchoscopic Lung Volume Reduction as Therapy in Chronic Obstructive Pulmonary Disease (COPD) Patients with Emphysema
Views: 741Downloads: 389BLVR is a combination of non-surgical techniques for lung volume reduction performed via bronchoscopy as an alternative to LVRS in emphysema patients. The techniques most often used in BLVR are bronchial valves (EBV/IBV), coils (lung coil), and thermal vapor (BTVA), while the BioLVR and ABS techniques have begun to be abandoned. BLVR is generally beneficial in improving lung function, exercise capacity, and quality of life in patients with emphysema. There is a need to monitor post-procedure side effects and long-term follow-up to assess the effectiveness of the procedure and reduce complications.
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The Art of Diagnosis from Breath Sound: A Literature Review
Views: 1,824Downloads: 3,747Breath sounds provide relevant information related to lung abnormalities. It is often difficult to differentiate between breath sounds, this is due to the different characteristics of each breath sound. Differentiating the types of breath sounds is crucial in making an accurate diagnosis. Breath sounds are divided into normal breath sounds and abnormal (additional) breath sounds. Normal breath sounds are sounds that originate from the chest wall, such as tracheal, bronchial, bronchovesicular and vesicular breath sounds. Meanwhile, abnormal (additional) breath sounds are breath sounds that indicate an abnormal condition in the respiratory system. Normal and abnormal breath sounds have different characteristics such as intensity, duration, frequency, quality of air flow, air flow pattern, air distribution, body position, location of sound production, changes in pressure and vibration of dense tissue in the lungs.
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Trends in Tongue Cancer in Tertiary Hospital in West Java for 5 Years: A Retrospective Study
Views: 468Downloads: 287Background: Oral cavity malignancy is the most common carcinoma of the head and neck. In the Western world, the tongue and floor of the mouth are the most common sites of origin for primary squamous cell carcinoma in the oral cavity. However, data and reports about tongue cancer is still limited, especially in Indonesia. The aim of this study is to get the epidemiological profile of tongue cancer in tertiary hospital in West Java from 2017 – 2021.
Methods: This study was a retrospective review of all patients with tongue cancer. The study used data from hospital information system from 2017 to 2021. Data collected were gender, age, histology, lymph node metastases. All data were analyze using statistical analysis program.
Results: Of the 120 cases analyzed. Sixty-eight of the 120 cases (56.67%) were found on female. The age group with the most cases was found in group of 51-60 years (35%). Histological examination showed 59 cases (49.17%) were squamous cell carcinoma well-differentiated, 28 cases (23.33%) showed lymph node regional metastases, and one case showed distant metastases to lung.
Conclusion: Tongue cancer profile in tertiary hospital in West Java mostly found in female with squamous cell carcinoma well-differentiated showed the most common. Of all cases, the spread to regional lymph nodes is only a few, not reaching thirty percent.
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Diagnosis and Current Management of Hepatocellular Carcinoma
Views: 582Downloads: 578Hepatocellular carcinoma (HCC) is a primary malignant liver tumor originating from hepatocytes which has a very poor prognosis and is ranked the sixth most common cancer disease in the world and is ranked third in deaths caused by cancer worldwide. Symptoms of underlying liver diseases such as hepatitis and cirrhosis often disguise the diagnosis of HCC so that most cases are discovered at an advanced stage. The examination modalities commonly used in surveillance are liver ultrasound (USG) examination and measurement of alpha levels fetoprotein (AFP) with sensitivity diagnostic up to 90%. Non-invasive imaging plays an important role in objective recognition and staging enforcement diagnosis as early as possible so that the patient's prognosis is better. Treatment for early-stage HCC can be given through curative therapy such as resection, liver transplantation, and local ablation, but disease at an advanced stage causes limited options in management where governance The current focus is on systemic therapy with a focus on a combination strategy of immunotherapy or a combination of targeted therapy with immunotherapy as the first line.
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Bullous Lung Disease (BLD): A Narrative Literature Review
Views: 1,386Downloads: 2,133Bullous lung disease (BLD) is often associated with spontaneous pneumothorax, but its role as a predisposing factor for recurrent pneumothorax is still not clearly revealed. Many factors are associated with lung BLD, but because BLD cases are still quite rare, efforts need to be made research further to find out more about the relationship between predisposing factors and BLD. Diagnosis of BLD by paying attention to the history, physical examination and appropriate radiological examination is necessary to determine whether surgery is necessary or not. Management of BLD has now developed with many different therapy options. The choice of invasive or non-invasive procedures is adjusted to clinical needs, equipment availability and medical personnel. Good treatment will of course provide satisfactory results, especially in terms of improving the patient's quality of life.
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Multilayered-Amniotic Membrane Transplantation in Gunshot Powder Injury: A Case Report
Views: 452Downloads: 319Background: Amniotic membrane transplantation has been widely used to repair various ocular surface conditions, including inflammatory, infectious, traumatic, and neoplastic conditions, with satisfactory results. a case of a 34-year-old male hit by a gunpowder explosion.
Case presentation: We reported a case of a 34-year-old male hit by a gunpowder explosion. The right eye was hyperemic and felt blurry after the incident. On examination of the right eye, visual acuity was 20/150, and foreign bodies and erosion were found in the cornea. The patient planned to do foreign body extraction followed by a multilayered-amniotic membrane transplantation (ML-AMT) procedure. On the first and second day of follow-up, on the right eye, the visual acuity was 1/300, palpebral edema was decreased, and subconjunctival hemorrhage was found. On the cornea, there were ML-AMT and bandage contact lenses.
Conclusion: Gunshot powder injury in the eyes is quite rare. The damage that can occur ranges from corneal epithelium abrasion to perforation and rupture of the eyeball. AMT has been successfully used in the management of eye trauma with defects on the ocular surface.
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Surfactant Therapy in Meconium Aspiration Syndrome: A Case Report
Views: 1,164Downloads: 542Background: Meconium aspiration syndrome (MAS) is one of many causes of respiratory distress in newborns. Data regarding MAS in Indonesia is still very limited, but a study revealed MAS is related to a high mortality rate. The latest study revealed surfactant therapy is related to better clinical outcomes in MAS cases. This study aimed to present a case of a baby with meconium aspiration syndrome given bolus surfactant therapy.
Case presentation: A day-old baby was referred to our emergency department with respiratory distress, delivered by cito caesarean section due to cephalopelvic disproportion with premature rupture of membranes. The baby didn’t cry immediately; bluish skin and green amniotic fluid were found. The baby was already intubated from the referring hospital, and the physical examination revealed rales on both lungs with severe work of breath. Chest radiography revealed patchy opacities in the right lung hemisphere, suggesting MAS. Echocardiography revealed a small patent ductus arteriosus, and head ultrasonography revealed mild brain oedema. The baby received bolus bovine surfactant therapy at 16 hours of age, delivered through an endotracheal tube. Clinical improvement was observed, and supplementary oxygen was reduced gradually. The baby was able to maintain good oxygenation without supplemental oxygen by day 12th and was able to breastfeed and drink from the bottle. He was discharged with good condition.
Conclusion: Surfactant therapy can become a safe and effective treatment modality in MAS. Further study is still needed regarding time, method, and types of surfactants used in MAS management.
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Recurrent Genital Herpes and Balanoposthitis Candidiasis in Men with Incomplete Circumcision: A Case Report
Views: 2,599Downloads: 898Background: Circumcision can reduce the risk of sexually transmitted diseases (STDs). It may reduce males acquiring HSV-2 by 30% and 68% lower prevalence of balanitis than uncircumcised males. There is no report of incomplete circumcision as a risk for STD infection.
Case presentation: A 31-year-old male complained of multiple ulcers that covered a yellowish crust on the penile with a burning sensation since 7 days ago. Initially, it was vesicles that turned into ulcers. One month ago, he complained of moist scales on his preputium that felt itchy and smelly. The patient is married and sexually active. History of intercourse with female sex workers without condoms 2 weeks ago. The patient had incomplete circumcision when he was a child; the preputium is still persistent and seldom cleaned regularly. One year ago, there was a history of vesicles on the penis. Physical examination revealed obesity grade 2. Venereological findings showed a whitish pseudo-membrane on the preputium, glans penis, and ulcers in various sizes covered pseudo-membrane surrounded erythema oedema. Laboratory revealed positive IgG HSV1, IgM, and IgG HSV2. A fungal culture is positive candida. Diagnosis established as recurrent genital herpes, balanoposthitis candidiasis, non-specific genital infection, candidiasis intertrigo. The patient has persistent preputium as the entry of commensal pathogens through abrasions in the mucosa, which causes infection. The patient had complete resolution after being administered oral acyclovir, doxycycline, and topical miconazole.
Conclusion: Persistent preputium in incomplete circumcision is a risk for developing candidiasis, balanoposthitis, and recurrent genital herpes.
