Accreditation
SINTA 2Nationally Accredited Journal
Vol. 8 No. 7 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Aspergilloma Mimicry of Lung Cancer: A Case Report
Views: 699Downloads: 600Background: Aspergilloma and lung cancer have similar risk factors, clinical features, and supporting features. Special supporting examinations are needed to rule out the differential diagnosis of aspergilloma.
Case presentation: A 52-year-old male patient with coughing up blood and risk factors for smoking had a chest X-ray and computed tomography scan (CT scan) of the thorax and found a picture of a lung tumor. Bronchoscopy was carried out, and a bronchial lavage culture was carried out for the impression of Aspergillosis, given 1x150 mg of fluconazole for 6 months with improved clinical results and chest radiographs as well as negative sputum culture results.
Conclusion: This patient showed the condition of aspergilloma mimicking lung cancer.
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Investigation of 3% Binahong (Anredera cordifolia) Leaf Extract Nanogel on the Alveolar Bone Healing: BMP-2 Modulation in Rat Models
Views: 622Downloads: 540Background: Alveolar bone healing relies on osteoblasts activity and differentiation, with bone morphogenetic protein-2 (BMP-2) playing a crucial regulatory role. Binahong leaf extract (BLE) has demonstrated efficacy in bone healing due to its rich phytochemical composition. Nanogel offers enhanced bioavailability and targeted release to effectively deliver therapeutic agents. This study aims to assess the impact of 3% BLE nanogel on BMP-2 expression in tooth extraction socket healing.
Methods: Thirty male Wistar rat underwent anaesthesia for the extraction of their lower incisors to induce alveolar bone healing. Subjects were randomly assigned into treatment (BLE nanogel) and control (base nanogel) group. Five rats from each group were respectively sacrificed at 7, 14, and 28 days after procedures. BMP-2 expression was assessed by performing immunohistochemistry analysis using BMP antibody reagent. Data were analysed using chi-square.
Results: The analysis of BMP-2 expression showed no significant difference between treatment and control groups on days 7, 14, and 28 (p>0,05). However, a subtle increase was observed in the treatment group throughout observation period.
Conclusion: Application of 3% BLE nanogel may enhance the expression of BMP-2, even though it was not significantly increase. The findings underscore the complex interplay between Binahong leaf extract, nanogel and BMP-2 expression.
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Differences in Mean Anti-Pertussis Antibody Levels in Children with Acellular Pertussis Immunization and Whole Pertussis Without Booster
Views: 499Downloads: 407Background: The incidence of pertussis is increasing every year, especially in developing countries. Low immunization coverage and decreased immunity are some of the factors causing the re-increase in pertussis cases. The protection provided by the pertussis vaccine whole and acellular pertussis given as a baby will decrease with age. This study aims to determine the difference in mean levels of anti-pertussis antibodies in children who received acellular pertussis and whole pertussis immunization without a booster.
Methods: A cross-sectional study was carried out at the pediatric polyclinic of Dr. M. Djamil General Hospital Padang from December 2022 to December 2023. Research subjects were children aged 5-9 years with a history of whole pertussis immunization (DPwT) 3 times or acellular pertussis immunization (DPaT) 3 times. The research subjects were examined for anti-pertussis antibody titers using the ELISA technique.
Results: Thirty-four children with a history of DPwT immunization 3 times and 34 children with a history of DPwT immunization 3 times were research subjects, with mean age 6.94±1.49 in the DPwT group and 6.88 ±1.61 in the DPaT group. The mean anti-pertussis antibody level in the DPwT group (9.54 IU/mL) was higher than the DPaT group (6.96 IU/mL) but was not statistically significant (p>0.05). The average antibody results showed that the antibody levels in both groups were below the antibody titer threshold that provides protection against pertussis. The results of the analysis showed that there was a significant difference in the incidence of AEFI between the DPwT and DPaT immunization groups (p<0.05).
Conclusion: There was no difference in anti-pertussis antibody levels in children who received DPwT and DPaT immunization 3 times. Pertussis immunization is a required booster so that antibody levels are sufficient to provide protection against pertussis.
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Collecting Duct Carcinoma in the Kidneys: A Rare Case Report
Views: 535Downloads: 293Background: Collecting duct carcinoma (CDC) is one of the rare pathological subtypes of renal cell carcinoma, with high malignancy and poor prognosis. Pathological examination is the gold standard in confirming the diagnosis of CDC. CDC is described as a tumor that has a tubulopapillary architecture and forms a hobnail pattern along the glandular tube.
Case presentation: A 56-year-old woman with the main complaint of a lump in the right abdomen for 1.5 months before entering the hospital. The lump in the stomach is getting bigger, complaints are accompanied by intermittent pain, nausea, vomiting, body feeling weak, and decreased appetite. The patient then underwent a CT-Scan examination of the abdomen and concluded that fluid/water was found next to the right kidney, and a hypodense lesion appeared in segment 6 of the right lobe of the liver. Histopathological examination of large tissue shows pieces of kidney tissue with a connective tissue capsule on the outside containing glomeruli and tubules lined by cuboidal epithelium as well as a proliferation of tumor cells that grow infiltratively in the connective tissue stroma which is partly desmoplastic and fatty tissue between the glomeruli and tubules. Tumor cells are arranged to form tubulopapillary and tubulocystic structures. These cells with pleomorphic nuclei, some hyperchromatic, some vesicular, coarse chromatin, clear nuclei, and atypical mitoses can be found and tumor cell embolism in the blood vessels and perineural invasion can be seen. There were spots and clusters of lymphocytes and plasma cells as well as areas of bleeding and necrosis.
Conclusion: The patient was diagnosed with collecting duct carcinoma (CDC).
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Hepatic Cirrhosis with Esophageal Varices: A Case Report
Views: 1,192Downloads: 420Background: In adults, portal hypertension is generally caused by hepatic cirrhosis, whereas in children it is more commonly caused by extrahepatic abnormalities with normal liver function. Portal hypertension causes hemodynamic abnormalities. Gastrointestinal bleeding is the most severe clinical manifestation of portal hypertension in both children and adults. Pathogenetically, increased pressure in the portal vein can be caused by increased vascular resistance and increased portal blood flow. The site of obstruction can be prehepatic (portal vein obstruction), intrahepatic (presinusoidal: eg congenital hepatic fibrosis; para sinusoidal: cirrhosis, hepatotoxic drug therapy, vitamin A hepatotoxicity; post sinusoidal: venocclusive disease) and/or post hepatic (Budd-Chiari syndrome, constrictive pericarditis).
Case presentation: The study reports the results of observations of a case of a boy, FAA, aged 12 years and 2 months who came to the emergency room at Dr. M. Djamil General Hospital Padang with the main complaint of hematemesis and splenomegaly from physical examination. Non cirrhotic portal fibrosis is a cause that is not uncommon in the population in the early second decade of life. Some children with non-cirrhotic portal fibrosis as adults can end up with end stage liver disease.
Conclusion: Patients with noncirrhotic or cirrhotic portal hypertension can be assessed using the Child Pugh instrument as an instrument that is still used to determine the survival rate if patients with portal hypertension.
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Overview of Pelvic Ring Fracture Patients: Observational Study in the Emergency Department at Dr. Kariadi General Hospital, Semarang, Indonesia
Views: 627Downloads: 347Background: Although the incidence of pelvic fractures is only 7% of all trauma, the mortality reaches 21.5%. Management of pelvic fractures remains a challenge because it is often a polytrauma that requires multidisciplinary management and large resources. Knowledge of the characteristics of patients with pelvic fractures is expected to help in management and reduce mortality.
Methods: This observational study was conducted retrospectively with a population and sample of all pelvic fracture patients in the emergency room at Dr. Kariadi Hospital Semarang for the period January 2021 to December 2023. The characteristics observed included gender, age, fracture classification, etiology, trauma score, fracture pattern, and management. and output. The data obtained is then presented descriptively.
Results: A total of 34 patients with pelvic fractures were recorded in this study. There were 16 male patients and 18 female patients. A total of 3 patients were less than 17 years old, 19 patients were 17-34 years old, 7 patients were 35-52 years old and 3 patients were more than 52 years old. The most common cause of pelvic fractures was traffic accidents (KLL) with 28 patients, followed by work accidents (4 patients) and other trauma (2 patients). Based on the Young-Burgess classification, the most common pelvic fracture pattern was LC1 (11 patients), followed by APC1 (3 patients), APC2 (4 patients), APC3 (3 patients), LC2 (2 patients), LC3 (6 patients), VS (4 patients), and CM (1 patient). A total of 4 patients had an ISS score of 1-8, 8 patients had an ISS score of 9-15, 9 patients had an ISS score of 16-25, and 13 patients had an ISS score of more than 25. The most common accompanying injury was long bone fracture (15 patients), head injury in 10 patients, abdominal trauma in 9 patients, and thorax trauma in 4 patients. Operative treatment was carried out in 21 patients, while 13 other patients were treated non-operatively. Of the 34 patients, 8 patients died and 26 others were discharged in good condition.
Conclusion: Most pelvic fractures occur at the age of 17-34 years and the most common cause is KLL. All pelvic fracture patients had concomitant injuries and the majority of patients had unstable fractures that required operative treatment. Mortality due to pelvic fracture and/or accompanying injuries is 23.5%.
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The Role of Rituximab in the Management of Heart Failure
Views: 666Downloads: 530Rituximab is a chimeric monoclonal antibody mice/humans that bind the transmembrane antigen, CD20 specifically. The mechanism of heart failure is mediated by neurohormonal pathways: the renin-angiotensin-aldosterone system (RAAS), the sympathetic nervous system, and the natriuretic peptide system, thereby triggering activation of the immune system. This literature review will discuss the role of B cell targeted therapy, in this case rituximab in the management of heart failure. Modulation of the immune response holds great promise in the 30% of cases of myocarditis where inflammation does not resolve and progression to chronic inflammatory dilated cardiomyopathy occurs. Pharmacologically, rituximab is a monoclonal immunoglobulin G1 antibody drug that is given intravenously. Rituximab targets the CD20 antigen expressed on the surface of mature B lymphocytes, including memory B cells but not on stem cells or plasma cells. In conclusion, rituximab causes a selective and temporary decrease in the CD20+ B cell subpopulation and represents a more specific and targeted approach to B cell-induced disorders including heart failure.
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The Role of Tecovirimat in the Management of Monkeypox
Views: 674Downloads: 439Monkeypox is a self-limited disease with symptoms that disappear within 14 to 21 days. Clinical management of monkeypox includes general supportive care and the use of antivirals that have activity against the monkeypox virus. This literature study aims to describe the role of tecovirimat in the management of monkeypox. Tecovirimat is an antiviral drug approved by the U.S. Food and Drug Administration (FDA) as part of the treatment management of smallpox in adults and children. Evidence of the efficacy of tecovirimat as mpox therapy was obtained from animal studies, where tecovirimat reduced mortality rates, reduced duration of illness and viral shedding. Tecovirimat inhibits the vp37 viral protein encoded by the F13 gene of the variola virus. This protein is highly conserved in orthopoxviruses, allowing tecovirimat to have in vitro activity against several orthopoxviruses, including vaccinia, variola, cowpox, and monkeypox viruses. In conclusion, tecovirimat is used in monkeypox sufferers with severe clinical conditions (sepsis, encephalitis, extensive lesions, bleeding manifestations), patients at risk of experiencing severe clinical conditions (immunocompromised, pregnant or breastfeeding, history of psoriasis, varicella zoster infection) and patients with one or more complications.
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Management of Isoniazid Monoresistant Tuberculosis
Views: 788Downloads: 527lsoniazid (INH) is one of the main first-line drugs used for the treatment of active tuberculosis (TB) and latent TB infection because it has bactericidal capabilities and a good level of safety. The presence of TB germs that are resistant to INH will reduce the effectiveness of TB treatment. The treatment mix for INH monoresistant TB patients is a combination of rifampicin (R), isoniazid (H), pyrazinamide (Z), ethambutol (E), and levofloxacin (Lfx) or R-H-Z-E-Lfx given for 6 months. If a health facility provides loose TB medication, the patient can be given a combination of treatment without INH (R-Z-E-Lfx). In conditions where the Lfx drug cannot be used because there is severe intolerance (serious adverse events) or there are contra indications, the treatment given is the R-H-Z-E combination for 6 months. Clinical monitoring for patients with INH monoresistant TB follows the same principles as treatment of drug-sensitive TB. In conclusion, the treatment guide for INH monoresistant TB patients is a combination of rifampicin (R), isoniazid (H), pyrazinamide (Z), ethambutol (E), and levofloxacin (Lfx) or R-H-Z-E-Lfx for 6 months.
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The Role of Subcutaneous Fat Composition on Blood Pressure: A Study on Students Aged 15-18 at Kalam Kudus II Senior High School Jakarta, Indonesia
Views: 645Downloads: 356Background: Hypertension is one of the leading causes of death worldwide. There was an increase in the prevalence of hypertension in children and adolescents ≤19 years of age from 2000 to 2015. Body mass index (BMI) and subcutaneous fat distribution are linked to blood pressure variations.
Methods: The cross-sectional study was carried out at Kalam Kudus II Senior High School Jakarta from June – August 2023. The inclusion criteria in this study included students of Kalam Kudus II Senior High School Jakarta, aged 15-18 years, registered as active students at the time the study was conducted, physically and spiritually healthy, and willing to participate in the study. The exclusion criteria for this study include students who refused participation, did not obtain permission from their parents, or students with medical disorders that affect anthropometric results and blood pressure. Data was taken from direct measurement and performed multivariate testing using the double linear regression test enter method in SPSS. The statistical significance is 0.05.
Results: An analysis of 102 students found that only BMI had a significant relationship with systolic blood pressure, and no anthropometric variable had a meaningful relationship with diastolic pressure.
Conclusion: There are many ways and factors for measuring body composition. It is important to test the body composition and BMI of adolescents to reduce the risk of hypertension later in the day.
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Supraclavicular Block Using Ultrasonography (USG) Guidance in Ulna Radius Fractures Patients with Moderate Mitral Regurgitation Undergoing ORIF (Open Reduction and Internal Fixation): A Case Report
Views: 735Downloads: 354Background: Open fractures of the radius and ulna in elderly patients are conditions that require fast and appropriate treatment. Open reduction internal fixation (ORIF) is a common treatment option, but in elderly patients, general anesthesia may be high risk. Supraclavicular brachial plexus block is an effective and safe regional anesthetic option for ORIF in elderly patients.
Case presentation: We report the case of a 71-year-old man with an open fracture of the left third radius and middle ulna who was planned for ORIF. The patient had comorbid hypertension and reduced left ventricular function. Supraclavicular brachial plexus block was performed using 0.5% bupivacaine (10 mL) and 2% lidocaine (10 mL). The patient did not complain of pain during the operation and recovered well.
Conclusion: Supraclavicular brachial plexus block is an effective and safe regional anesthetic option for ORIF in elderly patients with open fractures of the radius and ulna.
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A Case Report of 80-Year-Old Male with Total Atrioventricular Block, Acute Decompensated Heart Failure, and Non-ST-Elevation Myocardial Infarction Very High Risk: A Complicated Case in Limited Resources Setting
Views: 568Downloads: 429Background: Cardiovascular disease is still a major problem globally, with high morbidity and mortality rates. The progression of cardiovascular disease is so dynamic that it can leave the patient in a terminal condition. Given the high mortality and morbidity accompanied by rapid disease progression, understanding the appropriate management of each patient with comorbid heart disease is very important.
Case presentation: We report an 80-year-old male with TAVB (Total Atrioventricular Block), ADHF (Acute Decompensated Heart Failure), and NSTEMI (Non-ST-Elevation Myocardial Infarction). The patient was treated and stabilized intensively in our center based on protocol. Due to the rapid progression of the disease, we referred the patient to the tertiary hospital in Bali for further advanced treatment.
Conclusion: The mortality rate in cases of cardiovascular diseases is relatively high, requiring rapid and adequate treatment to provide better clinical outcomes.
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Freediving, Hypoxia, and Inflammation: Physiological Adaptations and Interactions between HIF and NF-κB
Views: 674Downloads: 733Freediving presents a unique set of physiological challenges and adaptations, making it a subject of interest for researchers studying the effects of extreme environmental conditions on the human body. There is a complex interplay between freediving, hypoxia, immune responses, and inflammation, shedding light on the physiological effects of freediving on the human body. This article describes how HIF and NF-κB interact during hypoxia and inflammation, including their synergistic effects and signaling pathways. The regulatory loop involving these transcription factors is highlighted, providing insight into their linked roles in modulating the cellular response to hypoxia and inflammation.
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The Effect of Snakehead Fish (Channa striata) Extract on Dry Socket Wound Healing: TGF-β1 Expression in Rats Model
Views: 1,190Downloads: 938Background: Dry socket or alveolar osteitis is a condition characterized by the breakdown of blood clots due to excessive fibrinolysis activity, which disrupts the wound healing process. Consumption of nutrition-rich foods such as snakehead fish (Channa striata) rich in albumin, omega-3 fatty acids, vitamins, minerals, and striatin may accelerate delayed wound healing. This study aimed to analyze the role of snakehead fish extract on the expression of TGF-β1 in the healing of dry socket wounds after tooth extraction in Wistar rats.
Methods: This study was an in vivo study with a posttest-only control group design. Forty-five Wistar rats were divided into five groups: snakehead fish extract groups with doses of 1/2, 1, 2, 4 times human dose, and a negative control. The lower left incisor teeth of the rats were extracted, then dry socket was induced with adrenaline using a paper point. On days 3, 7, and 14, TGF-β1 expression was assessed using immunohistochemical staining.
Results: This study showed significant difference in TGF-β1 expression on days 3, 7, and 14. TGF-β1 expression was higher in the treatment groups than the control (p<0.05).
Conclusion: Administration of snakehead fish extract increased TGF-β1 expression. These findings underline the complex interaction between snakehead fish extract and TGF-β1 expression.
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Analysis of Risk Factors for Psychological Stress in Breast Cancer Patients: Observational Study in West Java, Indonesia
Views: 655Downloads: 369Background: Breast cancer is one of the most common types of cancer in women in Indonesia. Diagnosis and treatment of breast cancer can cause significant psychological stress in the sufferer. This study aims to analyze the risk factors for psychological stress in breast cancer sufferers in West Java, Indonesia using an observational study with multivariate analysis.
Methods: This research involved 200 breast cancer sufferers recruited from hospitals in West Java. Data was collected using a questionnaire that measured psychological stress, demographic factors, social factors, and medical factors. Data analysis was carried out using multinomial logistic regression to identify risk factors associated with the occurrence of psychological stress.
Results: The research results show that the incidence of psychological stress in breast cancer sufferers in West Java is 42%. Risk factors that are significantly associated with the occurrence of psychological stress are young age, unmarried marital status, low social support, high levels of anxiety, and advanced cancer stage.
Conclusion: This research shows that several risk factors can increase the incidence of psychological stress in breast cancer sufferers in West Java. These findings can be used to develop more effective interventions to help breast cancer survivors cope with psychological stress.
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Correlation of High Sensitive Troponin I (hsTnI) with Platelet Distribution Width (PDW) in Acute Myocardial Infarction Patients
Views: 537Downloads: 259Background: Acute myocardial infarction (AMI) occurs due to rupture of atherosclerotic plaque which triggers platelet activation and aggregation to form a thrombus. Several studies have examined the relationship between PDW and AMI, but there is no specific correlation with hsTnI as the most sensitive and specific cardiac biomarker for AMI. This study aims to analyze the correlation between hsTnI levels and PDW values in AMI patients.
Methods: Cross-sectional study of 60 AMI patients in the emergency room of Dr. M. Djamil General Hospital Padang from April to August 2022. Research subjects who met the inclusion and exclusion criteria underwent hsTnI and PDW examinations. The correlation of hsTnI with PDW was analyzed using the Spearman correlation test. Correlation is declared significant if the p-value is <0.05.
Results: The research sample consisted of 48 men (80%) and 12 women (20%). The average age is 60.67 (10.73) years with an age range of 33-82 years. The mean hsTnI level was 2,606.10 (2,404.79) ng/Land the mean PDW value was 10.97 (2.26) fL. There was a strong and significant positive correlation between hsTnI and PDW in AMI patients (r = 0.618, p = 0.000).
Conclusion: There is a correlation between hsTnI levels and PDW values at AMI.
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Extramammary Paget's Disease of the Vulva: A Rare Case Report
Views: 742Downloads: 379Background: Extramammary Paget’s Disease (EMPD) is a rare disease characterized by intraepithelial involvement of the skin by non-squamous carcinoma cells in areas containing apocrine glands such as the vulva, perineum, perianal area, scrotum, and penis.
Case presentation: A 48 year old woman complained of a non-healing wound in the genital area for 1 year. The wound feels painful and does not bleed easily. No lumps were found anywhere else. The patient works as a private employee with minimal exposure to sunlight. No history of trauma. There is a history of surgical biopsy with the result of a malignant tumor with an impression Extramammary Paget Disease.
Conclusion: We present a case of a rare malignant tumor with EMPD impression of the vulva, extending to the perineum and suprapubic.
