Accreditation
SINTA 2Nationally Accredited Journal
Vol. 8 No. 4 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Combination Procedure for Acne Scars Revision, Is It Needed?
Views: 2,513Downloads: 7,154Background: The treatment of acne scars is a problem for dermatologist. Varied morphology of acne scars makes the treatment more difficult. Combination technique has high efficacy than monotherapy. The challenge is how to select best combination procedure for scar revision.
Case presentation: A 43-year-old male present with acne scars since 5 years ago. Dermatological findings revealed atrophic acne scars (ice pick, boxcar, rolling) types on forehead, nose and cheeks. Diagnosis established as moderate atrophic acne scars with global acne scarring system (GASS) is 21. Patient treated with blunt canula subcision, hyaluronic acid (HA) filler, microneedling radiofrequency, 90% trichloroacetic acid chemical reconstruction of skin scars (TCA CROSS) and application of salmon polydeoxyribonucleotide (PDRN). Patient also received topical 0.05% retinoic acid, 4% niacinamide, and sunscreen for daily. After 10 days, there is flattening and disappear of ice pick and boxcar, elevating of rolling scar, GASS score is 15. Blunt cannula subcision and HA filler is safe, effective for rolling scar through fibrous band breaking and prevent re-adhesion. Microneedling RF is effective for boxcar, otherwise 90% TCA CROSS preferrable for ice pick scars. This combination procedure leading cellular necrosis in epidermis, collagen in dermis, and stimulate regeneration. Application of Salmon PDRN may promote wound healing, hydrate the epidermis, and prevent dyschromia.
Conclusion: Combination of subcision, dermal filler, microneedling radiofrequency, 90% TCA CROSS, and Salmon PDRN has high efficacy for scar revision through collagen remodelling and acceleration wound healing.
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Cross-Sectional Study of Efficacy, Effectiveness, and Safety of Combination Creams (Tretinoin 0.05%, Clindamycin 3%, and Dexamethasone 0.05%) Anti-Acne – An Online Study
Views: 1,621Downloads: 777Background: Acne vulgaris is a common skin condition that causes blackheads, whiteheads, and pimples. It is caused by a number of things, like too much oil, clogged pores, and inflammation. Topical combination creams are an alternative treatment for acne. They can help reduce inflammation, kill bacteria that cause acne, and stop the skin from making too much oil. Topical combination creams like retinoids, antibiotics, and steroids are all mixed together in a single cream or gel. This study talks about the effectiveness and side effects of using combination creams (tretinoin 0.05%, clindamycin 3%, and dexamethasone 0.05%) to treat acne in the short and long term (local and systemic).
Methods: This study is a survey that was done at the Sukma clinic with data from 2022 patients who were diagnosed with acne vulgaris. The survey was done on Google Forms, which is a website. In this study, different factors were looked at, such as demographics, efficacy (like reducing acne severity, making the skin brighter, getting rid of blackheads on the face, getting rid of acne scars, improving skin texture, hiding scars, minimizing facial pores, getting rid of wrinkles and dark spots), local adverse events (like burning, itching, stinging, eruptive papules, hypopigmentation, hyperpigmentation, erythema, scaling, and other), and systemic adverse events.
Results: The results of this study show that a combination of tretinoin 0.05%, clindamycin 3%, and dexamethasone 0.05% is very effective and has minimal side effects. Local symptoms only show up during the first week of taking the drug (the "sensitization phase"), and then they tend to get less common over time. The only exceptions are hyperpigmentation and hypopigmentation, which show up later because they are caused by healing acne lesions.
Conclusion: There was no direct link between the use of anti-acne combination cream drugs and the number of systemic side effects. This is because the patient had often had this happen before (constipation, GERD, and others).
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A 56-Year-Old Man with an Unusual Projectile Trajectory of Gunshot Wound at Head and Neck Region: A Rare Case Report
Views: 894Downloads: 805Background: Gunshot injuries to the neck are linked to a substantial risk of high mortality and morbidity due to the presence of critical vascular and vital structures. However, there are rare instances where a bullet trajectory through the neck region avoids damaging these vital structures. In this context, we report a specific case involving a 56-year-old male who presented to the emergency department with a gunshot wound to the right maxilla through the left anterior neck region.
Case presentation: During the examination, a hematoma was observed in the left neck without an apparent entrance wound. The occurrence of a bullet injury to the neck without affecting any vital structures is exceptionally uncommon. Effectively managing patients with high-velocity penetrating injuries to the head and neck entails prioritizing tasks such as securing the airway, controlling hemorrhage, and promptly addressing any residual traumatic deformities for optimal outcomes. The presented case involves a gunshot injury to the head and neck, and a comprehensive review of the literature is provided.
Conclusion: Gunshot injuries to the head and neck are complex and serious, demanding swift and thorough medical attention. The case emphasizes the significance of post-surgery monitoring for potential complications, contributing valuable insights to the ongoing discourse on managing such injuries.
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Advantages of Using an Air Purifier for the Control of Atopic Dermatitis
Views: 902Downloads: 1,245Numerous studies have been carried out to ascertain the detrimental impact of air pollution on allergy conditions such as asthma, allergic rhinitis, and atopic dermatitis. Substandard indoor air quality exacerbates atopic dermatitis, which can be attributed to several reasons. Proper air circulation is crucial in households, especially in areas with high foot activity, since it can lead to elevated amounts of air contaminants entering the space. Indoor air pollutants, such as house dust mites, volatile chemical compounds, particle matter, and indoor mold, can aggravate atopic dermatitis. An air purifier effectively enhances the quality of indoor air. This gadget offers significant advantages for those with atopic dermatitis by effectively mitigating the frequency and intensity of disease relapses.
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Hair Transplant Follicular Unit Extraction Technique as a Current Treatment Option for Androgenetic Alopecia
Views: 894Downloads: 1,014The therapy for androgenetic alopecia currently varies, and there is no generally efficacious form of treatment. Despite receiving therapy, a portion of individuals with alopecia still do not achieve the anticipated hair regrowth outcomes. The absence of efficacious medical intervention typically necessitates the exploration of alternative therapy modalities. A significant number of patients who do not get satisfactory results from medical treatment explore other therapeutic approaches, such as hair transplantation. Advancements in hair transplantation procedures have seen substantial progress since the 1960s. Men frequently seek hair transplantation, making it a popular cosmetic treatment. Over 11,000 operations took place in the United States in 2014. Commonly practiced contemporary hair transplant procedures include follicular unit transplantation (FUT) and follicular unit extraction (FUE). The FUE technique is gaining popularity due to its non-invasive nature, quicker recovery time, reduced post-operative discomfort, and fewer surgical scars, in contrast to the FUT approach.
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Mycoplasma pneumoniae Infection: An Updated Narrative Review
Views: 656Downloads: 439Pneumonia cases in China, which rose sharply from October to November 2023, have received particular attention in the world of health. Chinese authorities said the trigger was not a new pathogen, one of which was Mycoplasma. Mycoplasma pneumoniae is a bacteria that can cause disease by damaging the lining of the respiratory system. Mycoplasma pneumoniae infection can occur in all age groups, especially at school and pre-school age. Most studies report that the age group that most often experiences Mycoplasma pneumoniae infection is those aged over 5 years. The importance of recognizing symptoms and providing adequate therapy is very necessary to treat pneumonia caused by Mycoplasma pneumoniae infection.
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The Role of CysC Levels as Biomarkers for Renal Function in the Use of Gentamicin for Preterm Infants Aged 28-36 Weeks with Neonatal Sepsis: A Narrative Literature Review
Views: 673Downloads: 446Premature infants with neonatal sepsis often require antibiotics, such as Gentamicin, commonly used in the NICU to treat suspected Gram-negative infections associated with neonatal sepsis. However, to limit the risk of nephrotoxicity associated with minimum levels, the use of high-dose Gentamicin with extended dosing intervals has been widely adopted in NICU clinical practice. Gentamicin use can impact kidney function. The examination of Cystatin C (CysC) levels as a biomarker to assess kidney function and nephrotoxicity due to antibiotic use is highly recommended, especially in premature infants. Gentamicin use in preterm infants can influence CysC levels as a biomarker for kidney function. The correlation between Gentamicin use, changes in CysC levels, and the impact on kidney function highlights the need for strict monitoring of these parameters. This study concludes that CysC levels can be a crucial indicator in assessing the impact of Gentamicin use on kidney function in preterm infants with neonatal sepsis. Routine monitoring of CysC levels can aid in early identification of potential kidney issues and support appropriate clinical decision-making in the use of antibiotics for this vulnerable preterm infant population.
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Pathophysiology and Management of Refractory Rheumatoid Arthritis: A Narrative Literature Review
Views: 1,620Downloads: 637Refractory rheumatoid arthritis is rheumatoid arthritis that fails to achieve low levels of disease activity using 2-3 DMARDS treatment and at least one other first-line bDMARD. The definition of refractory action is based on the number of failed DMARDs, the scale of the problem, and risk factors for a refractory disease course. Until now, there has been no further research discussing the pathophysiology of refractory RA, but it is known that TNF-α, IL-6, and IL-1 are the most important mediators that enable cell migration and inflammation in RA. IL-6 in particular, acts directly on neutrophils, which then contribute to inflammation and joint destruction by secreting proteolytic enzymes. The main goal to be achieved in RA is remission, low disease activity and an alternative goal for those who fail to achieve therapy targets. Currently, there are several bDMARD agents that can be used as therapy for refractory RA, namely TNF alfa inhibitors, B cell depletion agents, T cell activity inhibitors, and cytokine inhibitors.
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Cystic Fibrosis Lung Disease: A Narrative Literature Review
Views: 882Downloads: 1,197Cystic fibrosis (CF) is caused by mutations in autosomal recessive genes that code for proteins cystic fibrosis transmembrane conductance regulator (CFTR) which is located on chromosome seven. The CFTR protein under normal conditions acts as a chloride channel and helps the movement of sufficient electrolytes and water across the membrane. Mutations in CFTR cause abnormalities in chloride ion transport through epithelial cells and impaired sodium and water transport resulting in viscous secretions with low water content. This thick and sticky secretion will inhibit the normal function of various organs, although pulmonary complications are the most common cause of death. Cystic fibrosis has wide genotypic and phenotypic variations. There are six categories of mutations based on their effect on the CFTR protein, where these categories are not only used to predict the phenotype but also to determine better therapeutic strategies based on the identified mutations.
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Challenges in Diagnosing and Managing Uterus Didelphys: A Case Report
Views: 722Downloads: 1,968Background: This medical case report provides an insightful examination of a 22-year-old pregnant woman with uterus didelphys, a rare congenital anomaly of the Müllerian ducts. The introduction section sets the stage by discussing the embryological origins of congenital uterine anomalies and their varied clinical manifestations. It emphasizes the challenges in detecting these conditions due to their often asymptomatic nature and highlights their significant impact on reproductive health, including increased risks of miscarriage, preterm labor, and perinatal mortality.
Case presentation: The case report segment details the patient’s clinical presentation, initially misdiagnosed as an ectopic pregnancy, later revealed to be an intrauterine pregnancy coexisting with uterus didelphys. The diagnosis was substantiated by her history of irregular menstruation, lower abdominal pain since menarche, and a previously diagnosed ovarian cyst, illustrating the critical role of a thorough medical history in guiding diagnosis. The discussion section delves into the implications of uterus didelphys on fertility and pregnancy outcomes, advocating for individualized management strategies and highlighting the psychological impact of such congenital anomalies. It underscores the necessity of a multidisciplinary approach to care involving obstetricians, radiologists, and reproductive specialists.
Conclusion: The conclusion emphasizes the importance of clinical awareness, meticulous history-taking, and personalized care in the management of uterus didelphys. It calls for further research to enhance understanding and improve outcomes in reproductive medicine, stressing the complexity of diagnosing and managing pregnancies in women with Müllerian anomalies and the need to consider congenital uterine anomalies in differential diagnoses, particularly in young women with atypical gynecological histories.
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One and a Half Syndrome and Internuclear Ophthalmoplegia as Neuro-Ophthalmological Manifestations in Patients with Brainstem Stroke: A Case Series
Views: 797Downloads: 768Background: Brainstem stroke syndrome accounts for 10-15% of all types of strokes, which may result in relatively rare neuroophthalmological manifestations. The aim of this case report is to report findings of one and a half syndrome (OAHS) and internuclear ophthalmoplegia in a patient with brainstem stroke.
Case presentation: First case, female, 56 years old, came with sudden weakness on the right side of the body. One and a half syndrome was found, namely when asked to glance to the left, conjugate gaze palsy was obtained horizontally, and when asked to glance to the right, there was adduction inability of the left eye (ipsilateral). Right eye abduction was normal with present nystagmus. Paresis of right central CN. VII, XII was present, along with hemiparesis dextra (contralateral). Head CT scan shows hemorrhage in pons and intraventricular. Second case, female, 65 years old, came with a protruding mouth, vertigo, and sudden double vision Internuclear ophthalmoplegia was present, namely an adduction inability of the left eye (ipsilateral) when asked to glance to the right. Right eye abduction was normal with present nystagmus. no abnormalities were seen in the primary position and when asked to glance to the left. Paresis of right peripheral CN. VII, hemiparesis and right (contralateral) hemihypesthesia was present. MRI shows multiple chronic infarcts as well as subacute infarcts in bilateral parietal and pons.
Conclusion: Clinical knowledge is necessary for topic determination, rehabilitation process and evaluation.
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Burn Wound and Traumatic Inhalation due to Marapi Volcano Eruption
Views: 827Downloads: 526Background. Burns can be caused by various etiologies, including heat and chemicals from volcanic eruptions. Mount Marapi was a commonly visited hiking site prior to its eruption on December 3th 2023.
Case Presentation. This case reports a 19 year old woman with severe full thickness burns, covering 40.5% of total body surface area (TBSA) with inhalation trauma caused by inhaled volcanic ash from the Mount Marapi's eruption. Airway assessment was done through bronchoscopy examination.While being treated in the burn unit, the patient's overall condition deteriorated, so the patient was moved to the intensive care unit (ICU). Severe burns usually can cause circulatory disruption and trigger systemic inflammatory responses. Meanwhile, inhalation injury and sepsis also contributes to a higher risk of death in burn patients. Burns with inhalation trauma require specific treatment procedures.
Conclusion. This study summarizes the experience of treating victim of the Mount Marapi eruption and multidisciplinary approach to achieve optimal patient care.
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Successful Steroid Treatment of Extrahepatic Cholestasis: A Case Report
Views: 626Downloads: 553Background: Biliary atresia is the most common cause of cholestasis. However, not all healthcare facilities are capable of performing Kasai surgery and liver transplantation. The involvement of inflammatory processes in the bile ducts triggered by viral infections has been suggested in several theories of pathogenesis. This case report describes the successful steroid treatment of an infant with extrahepatic cholestasis.
Case presentation: A girl aged 2 months and 20 days presented with complaints of jaundice since the age of 2 weeks, with no improvement and worsening of the jaundice, with the color of the stools becoming paler than before. The nutritional status is normal. The physical examination revealed icteric sclera, hepatomegaly, and splenomegaly. There was cholestasis (total bilirubin 7.30 mg/dL and direct bilirubin 5.75 mg/dL), as well as elevated levels of AST (249 U/L), ALT (251 U/L), GGT (995.7 U/L) and increased to 1529.6 U/L, CMV reactive IgG 28.9, and Rubella reactive IgG 6.90. A two-phase ultrasound of the abdomen showed a thickening of the gallbladder wall. A liver biopsy showed mild portal fibrosis (F1). Steroids at a dose of 2 mg/kg/day in combination with ursodeoxycholic acid were administered. At follow-up one month later, the jaundice had improved. Stools were yellow-brown, and liver function tests and bilirubin were normal.
Conclusion: Adjunctive steroid therapy to suppress the inflammatory process in biliary obstruction may be beneficial in the early phase of the disease, especially in limited surgical and transplant settings.
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The Role of Hypoxia Inducible Factor (HIF) 1α in the Pathogenesis of Liver Cirrhosis: A Narrative Literature Review
Views: 555Downloads: 682The small changes in oxygen tension that occur during viral hepatitis, metabolic disorders, steatohepatitis, inflammation, and carcinogenesis are sufficient to increase hypoxic response, namely an increase in HIF. HIF is a protein that belongs to the PAS (period circadian protein-aryl hydrocarbon receptor nuclear translocator-single-minded protein) family. HIF regulates the adaptation of cells to oxygen. HIF is a transcription factor containing α and β subunits. The expression of the α subunit is oxygen-dependent, while the β subunit is expressed continuously and independently of oxygen. HIFs regulate various signaling events by binding to specific DNA sequences known as hypoxia response elements (HREs) in target genes, leading to an increase or decrease in their transcription. HIF-1α is a key regulator of hypoxia signaling.
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The Role of Anti-PD 1 (Programmed Cell Death-1) (Pembrolizumab) in Hepatocellular Carcinoma: A Narrative Literature Review
Views: 446Downloads: 393Hepatocellular carcinoma (HCC) is a malignant tumor originating from liver cells, HCC occurs in around 85% of patients diagnosed with cirrhosis. Treatment options for HCC consider liver function, extrahepatic spread, invasiveness, and the number and size of nodules. HCC therapy options include surgical resection, liver transplantation, tumor ablation, transarterial therapy and systemic chemotherapy. Pembrolizumab is a second-line systemic therapy option for the treatment of HCC after sorafenib therapy. Pembrolizumab is a class of immune checkpoint inhibitors (ICIs) and more specifically works as a programmed cell death-1 (PD-1) inhibitor.
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Gut Microbiota in Chronic Kidney Disease: A Narrative Literature Review
Views: 501Downloads: 611Chronic kidney disease (CKD) is a growing public health problem related to loss of kidney function and cardiovascular disease as the main causes of morbidity and mortality in CKD. It is known that CKD is associated with intestinal dysbiosis. There is an influence of the gut microbiota on the gut-kidney axis and it works reciprocally: on the one hand, CKD significantly changes the composition and function of the gut microbiota. On the other hand, gut microbiota is able to manipulate the processes that cause the emergence and progression of CKD through inflammatory, endocrine and neurological pathways. Understanding the complex interactions between gut and kidney microbiota may provide novel nephroprotective interventions to prevent the progression of CKD by therapeutically targeting balance of gut microbiota composition.
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Spinal Anesthesia with Ultrasonography (USG) Marker in Morbidly Obese Pregnant Women Undergoing Cesarean Section Surgery: A Case Report
Views: 605Downloads: 376Background: Spinal anesthesia is a regional anesthesia technique used to provide analgesia or numbness in the lower part of the body. This technique has long been employed in childbirth and cesarean section surgeries due to its numerous advantages for pregnant women. Obese pregnant patients often have increased adipose tissue in the back area, making it challenging to identify the appropriate interspinous space.
Case presentation: A 26-year-old primigravida at 38 weeks of gestation with morbid obesity, standing at 158 cm tall and weighing 140 kg, with a body mass index (BMI) of 56.1 kg/m², underwent cesarean section surgery under spinal anesthesia. The identification of the spinal needle insertion site was performed using pre-procedural ultrasound (USG) marker at the L3-L4 level, with heavy bupivacaine 0.5% 12.5 mg used as the anesthetic agent. The surgery lasted for 1 hour and 20 minutes, with stable hemodynamics and a blood loss of 450 ml. A female infant was delivered, weighing 3080 grams, with a length of 50 cm and an APGAR score of 8-9-10.
Conclusion: The use of USG markers can assist in determining the precise location for spinal anesthesia injection, thereby reducing complications from repeated needle insertions.
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Magnesium of Dead Sea Salts as a Key Factor for the Treatment of Seborrheic and Atopic Dermatitis: A Case Report
Views: 8,726Downloads: 2,734Background: Seborrheic and atopic dermatitis are common and chronic inflammatory skin diseases. Conventional treatments are often ineffective and can have significant side effects. Magnesium dead sea salt has a high concentration of magnesium, and previous research shows its potential to help improve skin conditions.
Case presentation: Patients with chronic seborrheic and atopic dermatitis were treated with topical 5% dead sea salt magnesium for 4 days. Patients experienced significant improvement in their symptoms.
Conclusion. Dead Sea salt magnesium can be a safe and effective treatment for seborrheic and atopic dermatitis.
