Accreditation
SINTA 2Nationally Accredited Journal
Vol. 8 No. 5 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Correlation of Soluble Programmed Death Ligand-1 (sPD-L1) with Alpha-Fetoprotein Levels as a Predictor of Prognosis in Hepatocellular Carcinoma Patients
Views: 440Downloads: 318Background: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and one of the leading causes of cancer death worldwide. Chronic hepatitis B virus infection is the most common etiology of HCC. Programmed death ligand-1 (PD-L1) is a protein that is overexpressed on the surface of tumor cells, which can be detected in serum (sPD-L1). Elevated sPD-L1 concentrations in the plasma of cancer patients are associated with poor prognosis in HCC patients, as indicated by increased AFP levels. There have been no previous studies examining the correlation of sPD-L1 levels with AFP in HCC patients. The aim of the study was to determine the correlation of sPD-L1 and AFP as predictors of prognosis in HCC patients.
Methods: The research is an observational study with a cross-sectional design to see the correlation of sPD-L 1 with serum alpha-fetoprotein levels in HCC patients at Dr. Mohammad Hoesin General Hospital Palembang starts from April to July 2023. Measurement of sPD-L1 levels and serum AFP levels is carried out using ELISA examination.
Results: Of the 28 subjects studied, HCC patients were more commonly found in men (89.29%) aged 18-60 years (75%). sPD-L1 and AFP values were found to be increased in the advanced stages of HCC. The sPD-L1 value is directly proportional to the serum AFP value.
Conclusion: There is a strong positive correlation between sPD-L1 levels and serum AFP levels caused by hepatitis B in HCC patients, so the higher the sPD-L1, the higher the serum AFP levels.
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Exploring The Interplay of Stunting and Upper Respiratory Infection in Kronjo Health Center: A Cross-Sectional Study
Views: 646Downloads: 455Background: Stunting, a prevalent form of chronic malnutrition, presents a significant public health challenge globally, particularly in low-income nations like Indonesia. This study investigates the prevalence and interaction of stunting and upper respiratory infections (URIs) among toddlers aged 12-59 months in Kronjo Health Center, a rural health center in West Java.
Methods: Employing a cross-sectional design with total sampling, data were collected from October to November 2023. Height measurements were interpreted according to WHO child growth standards, and statistical analysis was performed using the Pearson chi-square 2x2 test.
Results: The study involved 146 toddlers, with the majority being female (52.7%) and aged 12-23 months (34.9%). Most mothers had a high school education (39.7%), practiced breastfeeding (67.8%), and participated in basic pediatric immunization programs (61%). Additionally, 15 toddlers (10.3%) had a history of low birth weight, and a significant proportion were exposed to household smoking (n = 122; 83.6%) and lived in crowded households with six or more family members (n = 45; 30.8%). The study revealed a stunting prevalence of 46.6% and a URI prevalence of 63% among toddlers aged 12-59 months in Kronjo Health Center. Statistical analysis indicated a significant association between stunting and URIs (p-value = 0.035).
Conclusion: This study highlights a significant association between stunting and URI among toddlers aged 12-59 months in Kronjo Health Center, emphasizing the importance of addressing both conditions in rural health settings.
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The Effect of Activated Growth Factor (AGF) from Platelets on Alpha-SMA Levels in Osteoarthritis: Invivo Study
Views: 647Downloads: 424Background: The most prevalent joint condition and leading contributor to disability is osteoarthritis (OA), resulting in a significant socio-economic impact. It occurs due to an imbalance of pro-inflammatory and anti-inflammatory mediators, influencing anabolic and catabolic activities. This study aims to determine the effect of activated growth factor (AGF) on alpha-SMA levels.
Methods: This research is an in vivo post-test-only control group experimental study conducted at the Eureka Research Laboratory. Thirty male Wistar rats were divided into five treatment groups: normal control group, negative control group, AGF I group (TGF-β 100 pg/mL), AGF II group (TGF-β 1000 pg/mL), and AGF III group (TGF-β 10,000 pg/mL). AGF was obtained from rat blood intravenously and centrifuged at a predetermined speed. Growth factor activation was performed by adding 10% CaCl2, and then TGF-β levels were measured. All groups of rats were acclimatized for 7 days. After that, osteoarthritis was induced with intra-articular injection of monoiodoacetate (MIA) 4.8 mg/60μL in all groups of rats except the normal control group. Next, rats were given treatment according to the group for 21 days. On the 21st day, rats were euthanized, and alpha-SMA levels were measured using the sandwich method ELISA kit.
Results: Sequentially, the mean Alpha-SMA levels for each group in pg/mL were: 91.495 ± 2.36; 10.682 ± 1.09; 30.502 ± 2.00; 52.892 ± 1.29; and 76.180 ± 2.65. In the AGF group, there was an increase in alpha-SMA levels directly proportional to the dose of TGF-β injected.
Conclusion: AGF has an effect on increasing alpha-SMA levels in the joints of rats with a model of osteoarthritis.
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Complex Case: Acute-on-Chronic Gouty Arthritis, Septic Arthritis, and Severe Joint Deformities in a Young Adult Patient
Views: 620Downloads: 995Background: Gout is the most prevalent type of inflammatory arthritis, which can lead to inflammation in the joints. However, septic arthritis is unusual in gout.
Case presentation: A 34-year-old male presented with lumps on the right ankle with cloudy white fluid discharge for 5 days prior to admission. The patient also has lumps observed on the left pedis, and manus bilateral. The patient regularly takes Allopurinol daily and Piroxicam prior to admission. The physical examination had a limited range of movement. Laboratory examinations found elevated uric acid, impaired renal function, elevated white blood cells, and elevated erythrocyte sedimentation rate. The patient was then referred for surgical debridement.
Conclusion: Chronic gout marked by persistent polyarticular engagement and the formation of tophi. In individuals left untreated, septic arthritis and gout may manifest, followed by deformities of joints, which need further diagnosis and management.
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Bronchoscopy Diagnostic Procedures in Central and Peripheral Lesions: A Narrative Literature Review
Views: 573Downloads: 594Bronchoscopy is a medical procedure that provides tracheobronchial visualization by placing a bronchoscope and is carried out by a competent doctor. Bronchoscopy is the main interventional procedure used in determining the diagnosis and staging of cancer patients and plays a role in interstitial lung disease and infections. The basic principle of bronchoscopy sampling is carried out with a combination of rinsing, brushing, needle aspiration and biopsy. Cryobiopsy has advantages over conventional forceps biopsy and electrocautery because it can produce tissue without artifacts. Navigated bronchoscopy techniques have facilitated peripheral lung tumor biopsies that have better diagnostic yield than conventional transbronchial biopsies. The combination of navigation bronchoscopy with an ultrathin bronchoscope for peripheral lesions is more effective than either modality.
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The Complexities of Colorectal Cancer: A Case Report
Views: 911Downloads: 565Background: Colorectal cancer (CRC) is a malignancy that originates from the colon tissue (ascending, transverse, descending, sigmoid colon) and rectal tissue. Colorectal cancer is the fourth most common cancer in the world, and the second leading cause of cancer death. In Indonesia (2020), colorectal cancer was ranked sixth of the all malignancy diagnoses with a total of 17,368 new cases (4,4%).
Case presentation: a case of colon cancer (mucinous adenocarcinoma) in a 70 year old woman. Diagnosis was based on anamnesis of the presence onf intermitten abdominal pain, a mass in the right iliac region of the abdomen, and defecation accompanied by blood. On physical examination, there was tenderness and a mass in the right iliac region, and a positive Carnett’s sign. computer tomography (CT) of the urinary tract without contrast was performed and revealed a mass was found in the right abdomen, suspicious for the ascending colon and hepatic flexure of the colon, a cyst with a diameter of ± 3cm in the right kidney.
Conclusion: Anatomical patology (microscopic) results showed mucinous adenocarcinoma. The treatment for this patient was exploratory laparotomy, right hemicolectomy, and end to end anastomosis.
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A Suspicious Cup Disc with High Intraocular Pressure (IOP) and Normal Perimetry: A Rare Self Case Report
Views: 564Downloads: 429Background: Intraocular pressure (IOP) assessment involves evaluating the force exerted by aqueous humor on the internal surface of the anterior eye. Elevated IOP poses a substantial risk for glaucomatous optic neuropathy and is a key modifiable clinical risk factor. This study aims to explore cases of ocular hypertension coupled with optic nerve cupping, suspected to be glaucoma, providing comprehensive details of examination results, diagnosis, and subsequent management.
Case presentation: A 23-year-old Asian male underwent an ocular examination, revealing average IOP levels measured using non-contact tonometry. Despite no complaints, consecutive measurements noted 28 mmHg for the right eye and 26 mmHg for the left eye. Initial assessments by a glaucoma specialist indicated open-angle anterior chambers. Optical coherence tomography revealed cup disc ratios of 0.7 to 0.8 for both eyes. Medication (Timol) was prescribed, adjusting with oral citicoline and brinzolamide. The diagnosis evolved to juvenile open-angle glaucoma (JOAG). Visual field testing showed normal results. Discontinuation of treatment led to reclassifying the diagnosis as ocular hypertension and scheduling follow-up OCT examinations for five years.
Conclusion: The patient exhibited corneal thickness ≥610 μm, CDR ≥0.7 μm, IOP >25 mmHg, and maintained good visual field conditions. Additional research is essential to understand the correlation between corneal thickness and other eye conditions. Recognizing potential overdiagnosis due to high IOP and large CDR emphasizes the need for meticulous clinical assessment and advanced diagnostic examinations to distinguish physiological and pathological conditions.
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Efficacy of Metformin in the Prevention and Management of Paclitaxel Chemotherapy-Induced Peripheral Neuropathy: A Systematic Literature Review
Views: 567Downloads: 675Background: Peripheral neuropathy is a common side effect of paclitaxel chemotherapy that can cause tingling, numbness, and pain in the hands and feet. Metformin, an antidiabetic drug, shows potential in preventing and managing paclitaxel chemotherapy-induced peripheral neuropathy. This review article aims to evaluate the efficacy of metformin in the prevention and management of peripheral neuropathy due to paclitaxel chemotherapy.
Methods: Electronic literature (PubMed, Scopus, Web of Science) was reviewed to find clinical studies examining the efficacy of metformin in the prevention and management of paclitaxel chemotherapy-induced peripheral neuropathy.
Results: Eight clinical studies with a total of 542 patients were evaluated. Metformin significantly reduced the risk of developing peripheral neuropathy compared with placebo (OR = 0.54; 95% CI: 0.32-0.91). Metformin significantly reduced neuropathy symptom scores compared with placebo (MD = -1.52; 95% CI: -2.43 to -0.61). Metformin significantly improved patients' quality of life compared with placebo (MD = 0.48; 95% CI: 0.17-0.79).
Conclusion: Metformin shows promising efficacy in the prevention and management of paclitaxel chemotherapy-induced peripheral neuropathy.
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Parathyroid Adenoma with Multiple Bone Fractures: A Case Report
Views: 748Downloads: 290Background: Parathyroid adenoma is a benign neoplasm of the parathyroid glands and can result in hypercalcemia due to excessive secretion of parathyroid hormone (PTH). This elevated PTH can have various manifestations, including bone fractures.
Case presentation: We report the case of Tn. AB is a 41-year-old man with a series of recurrent bone fractures following minor traumas. Within a span of three years, he suffered from fractures in the right femur, left femur, and left humerus, which led to multiple surgeries, including total hip replacements. Further assessments showed an increased level of PTH and a suspicious lesion in the neck region. A CT scan revealed a potential parathyroid adenoma in the peritracheal region of the right side. Moreover, a Sestamibi scan confirmed an adenoma in the postero-inferior lobe of the right thyroid, consistent with Perrier type C, alongside osteoblastic processes and brown tumours. A subsequent parathyroidectomy confirmed a 2 cm diameter adenoma in the right lower parathyroid lobe. Histopathology from the excised tissue confirmed the diagnosis of parathyroid adenoma.
Conclusion: Parathyroid adenomas can have significant clinical manifestations, including recurrent bone fractures, due to their metabolic effects on bone integrity. Early detection and surgical intervention can prevent complications and improve the quality of life for these patients.
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T Cell Dysfunction in Systemic Lupus Erythematosus
Views: 709Downloads: 547Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease that can affect many organs in the body with very diverse clinical appearances. The prevalence of SLE in each country varies. The Lupus Foundation of America estimates that around 1.5 million cases occur in America and at least 5 million cases occur worldwide. The pathophysiology of SLE is very complex. The involvement of innate and adaptive immunity in the initiation and pathophysiology of SLE disease shows that there are interactions between leukocytes, cytokines, chemokines and tissue cells. T cells are the main component of the adaptive immune system which can kill infected host cells, activate other immune cells, produce cytokines and regulate immune responses. T cell dysfunction in SLE includes triggering inflammation through the secretion of pro-inflammatory cytokines, helping B cells produce autoantibodies and the accumulation of autoreactive T cells. Aberrations in T cells could be a therapeutic target for development and a potential SLE therapy.
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Factors Playing a Role in Sleep Disorders in Post-COVID-19 (Coronavirus Disease) Patients at the Neurology Polyclinic of Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Views: 571Downloads: 386Background: Sleep disorders are one of the symptoms frequently reported in post-COVID-19 patients. This study aims to identify factors that play a role in sleep disorders in post-COVID-19 patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
Methods: This research was conducted in an analytical observational manner with a cross-sectional design. Data was collected from 100 post-COVID-19 patients treated at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Data were analyzed using the logistic regression test.
Results: Factors that play a role in sleep disorders in post-COVID-19 patients are depressive symptoms (OR=2.5; 95%CI: 1.3-4.8); Anxiety symptoms (OR=3.1; 95%CI: 1.6-5.9); Stress level (OR=2.2; 95%CI: 1.1-4.3); Sleep quality before COVID-19 (OR=2.0; 95%CI: 1.0-3.9).
Conclusion: Symptoms of depression, anxiety, stress, and sleep quality before COVID-19 are factors that play a role in sleep disorders in post-COVID-19 patients.
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The Impact of COVID-19 Pandemic on Vitiligo Patient Visits in Tertiary Hospital: A Retrospective Study
Views: 523Downloads: 291Background: Vitiligo, a common depigmenting skin disorder, has an estimated prevalence of 0.5–2% of the population worldwide. The COVID-19 pandemic lockdown measures significantly affected the readiness of vitiligo patients to contact dermatologists. The aim of this study is to describe vitiligo patient visits during a pandemic situation.
Methods: A retrospective descriptive study, using secondary data obtained from Dr. M. Djamil General Hospital Padang medical records during the period of 2019–2021.
Results: During the pandemic (2020-2021), a total of 7 in 2020 and 19 in 2021 new vitiligo patient have been consulted. The ratio of male/female for two years was 16/10. The age of group 26-24 years had more frequently visited. A total 6 patients had segmental vitiligo and 16 patients had non segmental vitiligo. A total 4 patient had unstable vitiligo. During the pandemic, there were various vitiligo therapy such as oral and topical corticosteroid, topical immunomodulator, phototherapy, and punch grafting surgery. Compare to before the pandemic situation in 2019, a total 25 new vitiligo patient have been consulted in our outpatient clinic. Compared to 2019, the number of visits decrease significantly 72% in 2020 and 24% in 2021.
Conclusion: The pandemic COVID-19 had an unprecedented impact on number of vitiligo patient visits to the tertiary hospitals. This condition may affect visits and patient compliance. There were significant reductions in the number of outpatient visits due to pandemic COVID-19.
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Dermoscopy Evaluation of Erythema Dyschromicum Perstans Treated with Combination of Topical Steroid and Narrowband-Ultraviolet B: A Case Report
Views: 809Downloads: 446Background: Erythema dyschromicum perstans (EDP), also known as ashy dermatosis, is an uncommon, acquired, and persistent skin condition identified by development of hyperpigmented macules of varying sizes on the trunk, face, and extremities. It exact cause is unknown, and there is ongoing debate surrounding its treatment. Dermoscopic assessments may prove beneficial in evaluating the effectiveness of therapeutic interventions.
Case presentation: We present a case of a 20-year-old woman with numerous hyperpigmented macules of brown to slate-grey on her upper trunk, stomach, back, and extremities over the past three years. The patient reported no symptoms such as itching, numbness, or pain. Upon physical examination, mild anemia but otherwise healthy. On physical examination there are multiple brown-grey patches with reddish borders of varying sizes distributed across the body, with unaffected mucosa, scalp, palms, soles, and nails. Dermoscopic examination unveiled a widespread distribution of brown to grey backgrounds with a pinkish homogeneous appearance. Histopathological examination suitable for erythema dyschromicum perstans. The patient received a diagnosis of erythema dyschromicum perstans and underwent treatment involving a combination of topical steroids and Nb-UVB administered three times weekly for a duration of 8 weeks.
Conclusion: This condition presents a cosmetic concern throughout the patient's lifetime and significantly affects their quality of life. After 8 weeks of the combination of topical steroids and Nb-UVB, there was a improvement of erythema and lesion appear lighter. This observation suggests that a treatment with a consistently favorable outcome has not been identified and necessitates further investigation.
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Multiple Choledochal Cysts: A Case Report
Views: 459Downloads: 1,154Background: Choledochal cysts (CC) are congenital dilatations of the biliary tree, characterized by varying degrees of cystic dilatation at various segments of the biliary tract (extrahepatic or intrahepatic), may be detected at any age and in any portion of the bile duct. This study was aimed to present the management of multiple choledochal cyst case.
Case presentation: A 9 year old boy was brought by his mother to the emergency department at Dr. M. Djamil General Hospital Padang with chief complaint abdominal pain that’s getting worse 2 weeks before admission. Abdominal pain first complained by the patient since age of 4, the pain was felt all over stomach area, not localized, not radiated, not corelated with meal time, colicky, relieved with paracetamol. USG results: Choledochal cyst, Helicobacter pylori infection, elevated liver enzymes due to suspect suppression of choledochal cyst. Abdominal CT-Scan with contrast results: Intrahepatic and extrahepatic choledochal cyst (type IV A).
Conclusion: Patients was diagnosed with multiple choledochal cysts, diffuse peritonitis, Helicobacter pylori infection, and familial short stature.
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Profile of Urticaria and Angioedema Patients at Dr. Moewardi General Hospital Surakarta, Indonesia
Views: 849Downloads: 461Background: Urticaria is a heterogeneous inflammatory skin disease that results from the activation and degranulation of cutaneous mast cells, followed by the release of histamine and other mediators that cause sensory nerve activation, vasodilation, plasma extravasation, and recruitment of immune cells. The prevalence and incidence of urticaria and angioedema have been extensively studied worldwide, but there is still limited data in Indonesia, especially regarding the profile of urticaria and angioedema patients. The purpose of this study was to determine the profile of urticaria and angioedema patients at Dr. Moewardi General Hospital for the period January 1st, 2020 - December 31st, 2022.
Methods: This study is a cross-sectional retrospective study with secondary data derived from medical records of urticaria and angioedema patients.
Results: There were 152 patients with urticaria, most of whom were in the age group >60 years (20.39%), female with a male to female ratio of 1:1.92, and worked as housewives (17.76%) and students (16.45%). Most cases were diagnosed with urticaria (86.84%) with some patients having angioedema (13.16%). The most common comorbidities rhinoconjunctivitis (2.63%), atopic dermatitis (1.97%) and asthma (1.32%). The dominant symptoms were itching and bumps (100%). The main treatment received by patients was single AH1 (71.71%) followed by combination therapy of AH1 and systemic corticosteroids (14.47%), combination therapy of AH1 and topical corticosteroids (10.53%), and the rest received combination therapy of AH1, topical corticosteroids, and systemic corticosteroids (3.29%). The skin prick test was positive in 16 patients (35.56%), with the most common allergens found being peanut (37.5%), egg yolk (37.5%), and tomato (37.5%).
Conclusion: The characteristics of urticaria patients were dominated by elderly patients, female gender, and working as housewives or not working. Patients were predominantly diagnosed with urticaria with the most common comorbidities being diabetes mellitus. The main treatment received was AH1 class drugs. The most common types of allergens identified were peanuts, egg yolks, and tomatoes.
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Correlation Between APGAR Scores and the Incidence of Hyperbilirubinemia in Neonates at Wangaya Regional General Hospital, Denpasar
Views: 717Downloads: 492Background: Hyperbilirubinemia is defined as total serum bilirubin level at ≥ 5 mg/dl. In Indonesia, the prevalence of jaundice is 13,7-85%. One of the risk factors for hyperbilirubinemia in neonates is babies born with a history of asphyxia. The diagnosis of asphyxia can be enforced by the APGAR scoring system. This study aims to determine the relationship between APGAR values and the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital.
Methods: This research is an analytic observational study using a cross-sectional approach, which was carried out in April-May 2022. The sample was taken by consecutive sampling. Bivariate analysis was performed using the chi-square test. Confounding variables will be controlled by design and by analysis. Influential risk factors were analyzed multivariate with logistic regression. Data were analyzed with SPSS software.
Results: From 84 samples, 67, 9% had hyperbilirubinemia. The 1-minute APGAR score (P = 0,017, OR = 8,373, 95% CI; 1,468 – 47,738) and the 5-minute APGAR score (P = 0,034, OR =8,680, 95% CI; 1,172 – 64, 293) had significant correlation with the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital.
Conclusion: Low APGAR scores have a significant correlation with the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital. The factor that most influences the incidence of hyperbilirubinemia is the 1-minute APGAR score. Neonates born with a low 1-minute APGAR score are 8,3 times at risk of experiencing hyperbilirubinemia.
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Colonoscopy Finding: Pseudomembranous Colitis in Chronic Kidney Disease Patient
Views: 601Downloads: 361Background: Gastrointestinal symptoms are common among patients with chronic kidney disease, reported in up to 70%–80% of patients with end-stage kidney disease. Several factors are involved in the pathogenesis, including the accumulation of uremic toxins and intestinal flora changes. Pseudomembranous colitis is a manifestation of severe colonic disease that is usually associated with Clostridium difficile infection but can be caused by a number of different etiologies. Pseudomembranous colitis occurs when changes in the fecal flora allow Clostridium difficile overgrowth. Gut dysbiosis, an alteration of the composition and function of gut microorganisms, is commonly seen in patients with chronic kidney disease.
Case presentation: This scientific report presents a case study of a 31-year-old woman diagnosed with pseudomembranous colitis and end-stage chronic kidney disease on hemodialysis. The colonoscopy showed yellow-white nodules that formed pseudomembranes, which were scattered between the edematous mucosa. The patient had been treated with metronidazole for 4 days, but there were side effects. The antibiotic was switched to meropenem for 6 days based on feces culture. The evaluation of colonoscopy result was normal.
Conclusion: Pseudomembranous colitis is an inflammatory bowel condition most commonly caused by Clostridium difficile infection. The presence of pseudomembranous visualization in colonoscopy can significantly establish the diagnosis.
