Accreditation
SINTA 2Nationally Accredited Journal
Vol. 8 No. 10 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Analysis of the Role of SARS-CoV-2 Infection on Clinical Superficial Mycosis: An Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Views: 529Downloads: 374Background: The COVID-19 pandemic, caused by SARS-CoV-2 infection, has had multiple impacts on human health, including its potential influence on the manifestation and severity of skin diseases such as superficial mycoses. This study aims to analyze the relationship between SARS-CoV-2 infection and the clinical characteristics of superficial mycosis in patients at Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: This analytical observational study included 150 patients with laboratory-confirmed superficial mycoses. Demographic data, medical history, SARS-CoV-2 infection status (based on RT-PCR results), and clinical characteristics of superficial mycoses were collected and analyzed using SPSS software.
Results: Of the 150 patients studied, 75 patients had a history of SARS-CoV-2 infection. No significant differences were found in the distribution of gender, age, and location of superficial mycosis infections between the groups of patients with and without SARS-CoV-2 infection. However, patients with a history of SARS-CoV-2 infection tended to have a higher severity of superficial mycosis (p < 0.05). In addition, there was a significant difference in the type of agent causing superficial mycosis between the two groups (p < 0.01).
Conclusion: SARS-CoV-2 infection may influence the clinical manifestations of superficial mycoses, especially in terms of disease severity. These findings support the importance of monitoring and management of superficial mycoses in patients with a history of SARS-CoV-2 infection.
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Comparison of Immature Platelet Fraction (IPF) Values for ACS Patients with Unstable Angina Pectoris (UAP), Non-ST Elevation Myocardial Infarct (NSTEMI), and ST Elevation Myocardial Infarct (STEMI)
Views: 566Downloads: 399Background: Acute coronary syndrome (ACS) is a medical emergency that requires rapid diagnosis and treatment. Immature platelet fraction (IPF) is a hematological parameter that has the potential to be a biomarker for differentiating types of ACS. This study aims to compare IPF values in ACS patients with unstable angina pectoris (UAP), Non-ST elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI).
Methods: This research is an analytical observational study with a cross-sectional design. The research subjects were ACS patients treated at Dr. M. Djamil General Hospital, Padang, Indonesia between January 2023 to December 2023. IPF values were measured using the Sysmex XN-1500 tool. Statistical analysis was carried out using the ANOVA test and post-hoc Tukey test.
Results: A total of 150 ACS patients (50 UAP, 50 NSTEMI, 50 STEMI) were included in this study. The mean IPF value in the STEMI group (6.8 ± 2.1%) was significantly higher than that in the NSTEMI (4.5 ± 1.8%) and UAP (3.2 ± 1.5%) groups (p < 0.001). ROC analysis showed that the IPF value had an AUC of 0.89 (95% CI: 0.84-0.94) for differentiating STEMI from NSTEMI/UAP.
Conclusion: IPF values were higher in STEMI patients compared to NSTEMI and UAP. This parameter has the potential to be a biomarker for differentiating types of ACS, especially in differentiating STEMI from NSTEMI/UAP.
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Analysis of Bioterrorism Studies on Lung Health: A Meta-Analysis
Views: 689Downloads: 481Background: Bioterrorism, the use of biological agents to cause mass harm, poses a significant threat to lung health. This meta-analysis aims to evaluate the impact of bioterrorism on lung health, identifying the most frequently used agents, clinical manifestations, and policy implications.
Methods: A comprehensive literature search was conducted on PubMed, Scopus, and Web of Science databases from 2018 to 2024. Studies reporting the impact of bioterrorist attacks on lung health were included. Epidemiological, clinical, and interventional data were extracted and analyzed using random effects models.
Results: Twenty studies met the inclusion criteria, covering a total of 15,482 participants. The most common bioterrorism agent was Bacillus anthracis (43.5%), followed by Yersinia pestis (21.7%) and Francisella tularensis (17.4%). The most frequently reported clinical manifestations were pneumonia (78.3%), acute respiratory failure (39.1%), and sepsis (26.1%). Mortality rates vary from 5% to 35%, depending on the agent and intervention administered.
Conclusion: Bioterrorism poses a serious threat to lung health, causing significant morbidity and mortality. Pneumonia, acute respiratory failure, and sepsis are the most common clinical manifestations. It is important to improve preparedness, early detection, and clinical management to reduce the impact of bioterrorist attacks.
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Analysis of Risk Factors and Predictors of Endoscopic Findings in Patients with Gastrointestinal Disorders: A Single Center Observational Study at Sanjiwani General Hospital, Gianyar, Bali, Indonesia
Views: 531Downloads: 326Background: Gastrointestinal disorders are a common health problem in Indonesia. Endoscopy is an important procedure in diagnosing and managing this disorder. This study aims to analyze risk factors and predictors of endoscopic findings in patients with gastrointestinal disorders at regional hospitals in Bali.
Methods: This research is an analytical observational study with a cross-sectional design. The research subjects were patients with gastrointestinal disorders who underwent endoscopy at regional hospitals in Bali during the period January 2022 to December 2023. Data was collected through medical records and interviews. Data analysis was carried out using the Chi-square test and logistic regression.
Results: A total of 1074 patients were included in this study. The mean age of patients was 45.3 years (SD 15.2). The most common endoscopic finding was gastritis (35.2%), followed by gastric ulcer (15.8%) and esophagitis (12.4%). Risk factors that were significantly associated with endoscopic findings were age > 45 years (OR 1.78; 95% CI 1.23-2.57), male gender (OR 1.54; 95% CI 1.11- 2.14), history of smoking (OR 2.31; 95% CI 1.65-3.24), and history of use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR 1.98; 95% CI 1.39-2.82).
Conclusion: Age > 45 years, male gender, smoking history, and history of NSAID use are risk factors that are significantly associated with endoscopic findings in patients with gastrointestinal disorders at regional hospitals in Bali.
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Systemic Metastase in Late Management of Group D Retinoblastoma: A Case Report
Views: 541Downloads: 288Background: Retinoblastoma (RB) is a common malignancy that affects children and is fatal if left untreated. This case report aims to raise awareness the importance of starting therapy immediately in RB patients.
Case presentation: A girl aged 1 year 9 months, came with complaints that her left eye (LE) appeared white for 2 weeks. Anterior segment examination was normal. On funduscopic examination, optic nerve was difficult to evaluate, covered by a mass, multiple mass scars on the retina, a size of > 6 mm at the posterior pole, and vitreous seeding. Ultrasound examination and CT scan showed an intraocular mass with calcification. The patient was diagnosed with group D intraocular LE RB and was planned for enucleation but was postponed due to cost constraints. The patient came back after 1 year and was diagnosed with extraocular LE RB stage IVB.
Conclusion: Early diagnosis without adequate therapy leads to tumor spread and reduces patient survival.
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Analysis of Risk Factors for Cognitive Frailty: A Meta-Analysis
Views: 647Downloads: 370Background: Cognitive frailty (CF) is a syndrome characterized by cognitive and physical decline in older adults, which increases the risk of disability, dependency, and mortality. This study aims to identify and analyze risk factors for CF incidence through a systematic review and meta-analysis.
Methods: A literature search was conducted on PubMed, Scopus, and Web of Science databases until June 2024. Observational studies reporting associations between potential risk factors and CF incidence in the elderly population were included. Two independent researchers performed study selection, data extraction, and risk of bias assessment. Meta-analysis was performed using a random effects model, and heterogeneity between studies was evaluated.
Results: A total of 25 studies (n=45,678 participants) met inclusion criteria. Meta-analysis showed that advanced age (OR=1.89; 95% CI 1.65-2.16), female gender (OR=1.38; 95% CI 1.19-1.60), history of cardiovascular disease (OR=1.52; 95% CI 1.23-1.87), diabetes mellitus (OR=1.45; 95% CI 1.18-1.78), depression (OR=2.08; 95% CI 1.72-2.51), and low physical activity (OR=1.63; 95% CI 1.35-1.97) are risk factors significant for the incidence of CF. Low educational level (OR=1.71; 95% CI 1.43-2.04), low socioeconomic status (OR=1.58; 95% CI 1.29-1.93), and smoking history (OR=1.31; 95% CI 1.05-1.64) were also associated. with an increased risk of CF.
Conclusion: This study identified several modifiable and nonmodifiable risk factors for CF occurrence. Interventions targeting these risk factors may help prevent or delay the development of CF in older adults.
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Analysis of Probiotic Role in Non-Alcoholic Fatty Liver Disease (NAFLD) Management: A Meta-Analysis
Views: 796Downloads: 365Background: Non-alcoholic fatty liver disease (NAFLD) is an increasing global health problem. Probiotics have emerged as a potential therapy for NAFLD, but evidence for their efficacy remains mixed. This meta-analysis aims to evaluate the effectiveness of probiotics in the management of NAFLD.
Methods: A comprehensive literature search was performed on PubMed, Embase, Cochrane Library, and Web of Science databases until December 2023. Randomized controlled trials (RCTs) evaluating the effects of probiotics in NAFLD patients were included. The main outcomes evaluated were changes in liver enzymes (ALT, AST), insulin resistance index (HOMA-IR), and hepatic steatosis score. Meta-analysis was performed using a random effects model, and heterogeneity was assessed using the I² statistic.
Results: Twenty-five RCTs involving 1845 patients met inclusion criteria. Meta-analysis showed that probiotics significantly reduced ALT (MD -8.45; 95% CI -12.67 to -4.23; p<0.0001) and AST (MD -6.89; 95% CI -10.11 to -3.67; p<0.0001) levels compared with placebo. Significant reductions were also observed in HOMA-IR (MD -0.68; 95% CI -1.02 to -0.34; p<0.0001) and hepatic steatosis scores (SMD -0.45; 95% CI -0.71 to -0.19; p=0.0008). Subgroup analysis showed that the effects of probiotics were more pronounced in patients with NAFLD non-alcoholic steatohepatitis (NASH) and those receiving multi-strain probiotics.
Conclusion: This meta-analysis provides strong evidence that probiotics have beneficial effects on biochemical and imaging parameters in NAFLD patients. Probiotics may be considered as an adjunct therapy for NAFLD, especially in patients with NASH. However, more research is needed to determine the optimal probiotic strain, dosage, and duration of treatment.
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Challenges of Diagnosis and Management of Complex Febrile Seizures in Infants: A Case Study
Views: 942Downloads: 572Background: Complex febrile seizures (KDK) are a type of febrile seizure that is more severe than simple febrile seizures (KDS), characterized by longer duration, recurrence within 24 hours, and/or focal onset. KDK can be a diagnostic and therapeutic challenge, especially in infants.
Case presentation: This case report presents a 1-year-old baby girl who was treated in the emergency department (ER) with complaints of recurrent seizures and persistent fever. Physical examination revealed fever and tachypnea, while laboratory examination revealed hyperglycemia, hyperkalemia, hyponatremia, and decreased hematocrit. The patient's history indicated previous episodes of febrile seizures, but no significant family history.
Conclusion: The patient was diagnosed with KDK and given fluid resuscitation, antipyretics, anticonvulsants, and antibiotics. The patient's parents are educated about KDK and its management. The patient's prognosis is considered good, with a small chance of long-term neurologic sequelae if treated appropriately.
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The Role of NT-proBNP in the Diagnosis of Peripartum Cardiomyopathy with Multiple Left Ventricular Thrombus: A Case Report
Views: 790Downloads: 318Background: Peripartum cardiomyopathy (PPCM) is a rare but serious condition characterized by left ventricular dysfunction in late pregnancy or early postpartum. Early diagnosis is essential to prevent complications such as thromboembolism. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a promising biomarker for the diagnosis of PPCM.
Case presentation: An 18-year-old female presented with progressive shortness of breath and generalized edema. Physical examination and echocardiography revealed acute heart failure with multiple left ventricular thrombus. Very high levels of NT-proBNP (1,796 pg/mL) supported the diagnosis of PPCM. The patient was successfully treated with standard heart failure therapy and anticoagulants.
Conclusion: This case report highlights the importance of NT-proBNP in the early diagnosis of PPCM and detecting of thromboembolic complications. Significant increases in NT-proBNP levels, even without obvious symptoms, should be promptly evaluated for PPCM, especially in high-risk populations.
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Screening and Identification of Erythrocyte Antibodies: A Narrative Literature Review
Views: 950Downloads: 581Red blood cell (RBC) alloimmunization, the development of antibodies against foreign red blood cell antigens, is a critical concern in transfusion medicine. Alloantibodies can lead to adverse transfusion reactions, including hemolytic disease of the fetus and newborn (HDFN) and delayed hemolytic transfusion reactions (DHTR). This comprehensive literature review explores the intricacies of RBC alloimmunization, focusing on the screening and identification of erythrocyte antibodies. We delve into the prevalence and clinical significance of various alloantibodies, the underlying immunological mechanisms, and the evolution of laboratory techniques for their detection. Additionally, we discuss the challenges and future directions in managing alloimmunization, emphasizing the importance of personalized medicine and innovative approaches to ensure safe and effective blood transfusions.
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Intralesional Mumps, Measles, Rubella (MMR) Vaccine as Therapy for Recurrent Condyloma Acuminata: A Case Report
Views: 776Downloads: 521Background: Condyloma acuminata (CA), a prevalent sexually transmitted infection caused by the human papillomavirus (HPV), presents challenges in treatment due to its high recurrence rate. While various treatment modalities exist, intralesional immunotherapy with the mumps, measles, rubella (MMR) vaccine has shown promise in managing HPV-related conditions. This case report investigates intralesional MMR vaccine in treating recurrent CA.
Case presentation: A 24-year-old female presented with recurrent CA lesions on the labia majora and perianal region. Despite prior treatment with trichloroacetic acid (TCA), the lesions had reappeared. Intralesional MMR vaccine injections were administered twice, one month apart, resulting in complete lesion resolution within six weeks of the second injection. No recurrence was observed during a six-month follow-up period, and the patient reported only mild, transient pain at the injection sites.
Conclusion: This case report highlights the potential of intralesional MMR vaccine as an effective and well-tolerated treatment option for recurrent CA. Further research is warranted to validate these findings and establish optimal treatment protocols.
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Premature Rupture of Membranes in a Pregnant Patient with Systemic Lupus Erythematosus and Lupus Carditis: A Case Report
Views: 500Downloads: 342Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease associated with significant maternal and fetal risks, especially during pregnancy. Lupus carditis and premature rupture of membranes (PROM) pose additional challenges in managing such pregnancies.
Case presentation: A 21-year-old woman with a history of SLE and lupus carditis presented at 34 weeks gestation with premature rupture of membranes. Her medical history was notable for regular follow-up and treatment for SLE manifestations, including mucocutaneous involvement and microcytic hypochromic anemia. Physical examination revealed characteristic signs of SLE, and echocardiography confirmed dilated cardiomyopathy. Following a multidisciplinary approach, a cesarean section was performed, resulting in the successful delivery of a healthy neonate.
Conclusion: This case highlights the importance of a coordinated multidisciplinary approach in managing complex pregnancies involving SLE, lupus carditis, and PROM. Early diagnosis, close monitoring, and timely intervention are crucial for optimizing maternal and fetal outcomes in such cases.
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Serum Uric Acid and Nitric Oxide Levels in Relation to Coronary Artery Occlusion Severity in STEMI (ST Elevation Myocardial Infarct): A Meta-Analysis
Views: 566Downloads: 253Background: Serum uric acid (SUA) and nitric oxide (NO) are implicated in cardiovascular disease pathogenesis. However, their relationship with the degree of coronary artery occlusion in STEMI patients remains unclear. We aimed to synthesize available evidence on the association between SUA, NO levels, and coronary artery occlusion severity in STEMI.
Methods: We conducted a systematic search of PubMed, Embase, and Cochrane Library databases from 2018 to 2024 for studies reporting SUA and NO levels in STEMI patients undergoing percutaneous coronary intervention (PCI). We extracted data on occlusion severity (e.g., thrombolysis in myocardial infarction [TIMI] flow grade) and performed a meta-analysis using random-effects models.
Results: Ten studies involving 2515 STEMI patients were included. The pooled analysis revealed a significant positive association between SUA levels and a higher degree of coronary artery occlusion (standardized mean difference [SMD] = 0.35, 95% confidence interval [CI] 0.12-0.58, p = 0.003). Conversely, NO levels were significantly lower in patients with more severe occlusion (SMD = -0.28, 95% CI -0.45 to -0.11, p = 0.001).
Conclusion: Elevated SUA and reduced NO levels are associated with increased coronary artery occlusion severity in STEMI patients. These findings highlight potential therapeutic targets for improving outcomes in STEMI.
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A Rare Primary Breast Angiosarcoma with Bone Metastasis: A Case Report
Views: 566Downloads: 290Background: Angiosarcoma is a rare and aggressive malignant tumor originating from endothelial cells. Primary breast angiosarcoma (PBA) is exceedingly uncommon, accounting for less than 1% of all breast malignancies. Bone metastasis from PBA is even rarer, making it a unique clinical entity.
Case presentation: We present the case of a 37-year-old woman who initially presented with a rapidly enlarging breast mass. A biopsy confirmed the diagnosis of PBA, and she underwent a modified radical mastectomy followed by radiotherapy. Seventeen months later, she developed progressive lower extremity weakness and urinary and bowel incontinence. Imaging revealed a spinal metastasis at the Th4-Th6 level. Biopsy and immunohistochemistry confirmed metastatic angiosarcoma. The patient underwent laminectomy and posterior stabilization.
Conclusion: This case highlights the rarity and aggressive nature of PBA with bone metastasis. It emphasizes the importance of early detection, comprehensive treatment, and long-term surveillance in managing this challenging disease. Further research is needed to understand the underlying mechanisms and develop effective therapeutic strategies for PBA with bone metastasis.
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The Role of Receptor-Interacting Serine/Threonine-Protein Kinase 1 (RIPK1) in CD4+ T Cell Necroptosis in HIV Patients: A Narrative Literature Review
Views: 485Downloads: 291The human immunodeficiency virus (HIV) remains a global health challenge, with its ability to deplete CD4+ T cells, leading to acquired immunodeficiency syndrome (AIDS). While apoptosis has been extensively studied in CD4+ T cell depletion, recent research has highlighted the significant role of necroptosis, a regulated form of necrosis, in this process. Receptor-interacting serine/threonine-protein kinase 1 (RIPK1) has emerged as a central player in necroptosis, regulating both cell death and inflammatory responses. This review delves into the intricate mechanisms by which RIPK1 orchestrates necroptosis in CD4+ T cells during HIV infection. We explore the structural intricacies of RIPK1, its interactions with other signaling molecules, and the downstream events that culminate in necroptotic cell death. Additionally, we discuss the therapeutic potential of targeting RIPK1 to mitigate CD4+ T cell loss and control HIV disease progression. Understanding the multifaceted role of RIPK1 in HIV-induced necroptosis may pave the way for novel therapeutic interventions to combat this devastating disease.
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A Meta-Analysis of Electric Cigarette Use and Lung Health Implications
Views: 901Downloads: 708Background: The global rise in electric cigarette (e-cigarette) use has prompted urgent investigation into their health effects. This meta-analysis aims to consolidate evidence regarding the impact of e-cigarette use on lung health.
Methods: A systematic search of PubMed, Embase, and Cochrane Library databases was conducted, identifying studies published between 2018 and 2024 that assessed lung function, respiratory symptoms, and lung disease incidence in e-cigarette users. Studies meeting inclusion criteria were subjected to quality assessment and data extraction. Random-effects models were used for pooled analysis, and heterogeneity was assessed.
Results: Twenty-three studies, encompassing 12,456 participants, were included. E-cigarette use was associated with a small but significant decrease in forced expiratory volume in 1 second (FEV1) (standardized mean difference [SMD] -0.18, 95% CI -0.26 to -0.10, p<0.001). Increased odds of wheezing (odds ratio [OR] 1.38, 95% CI 1.15 to 1.65, p=0.001) and chronic cough (OR 1.25, 95% CI 1.08 to 1.44, p=0.003) were also observed in e-cigarette users. No significant association was found with chronic obstructive pulmonary disease (COPD) incidence.
Conclusion: E-cigarette use appears detrimental to lung function and associated with respiratory symptoms. Further long-term research is imperative to establish definitive conclusions on the risk of COPD and other lung diseases.
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Risk Factors for Sleep Disorders in Patients with Chronic Pain: A Meta-Analysis
Views: 660Downloads: 621Background: Chronic pain and sleep disorders frequently co-occur, exacerbating each other in a vicious cycle. This meta-analysis aimed to identify and quantify risk factors associated with sleep disorders in individuals experiencing chronic pain.
Methods: A systematic search of PubMed, Embase, Web of Science, and Cochrane Library databases was conducted from January 2018 to June 2024. Studies assessing sleep disorders (insomnia, obstructive sleep apnea, restless legs syndrome) in adults with chronic pain (non-cancer pain lasting >3 months) were included. Data on demographics, pain characteristics, sleep measures, and potential risk factors were extracted. Meta-analyses were performed using random-effects models to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs).
Results: Twenty-seven studies (n = 12,453 participants) met the inclusion criteria. Chronic pain significantly increased the odds of having any sleep disorder (OR 2.83, 95% CI 2.19-3.65). Specific risk factors identified included: Female gender: OR 1.41 (95% CI 1.18-1.67); Higher pain intensity: OR 1.15 per 1-unit increase on a 0-10 scale (95% CI 1.08-1.23); Longer pain duration: OR 1.04 per year (95% CI 1.01-1.07); Presence of depression or anxiety: OR 2.32 (95% CI 1.85-2.91); Use of opioid medications: OR 1.58 (95% CI 1.23-2.04).
Conclusion: Chronic pain is a substantial risk factor for sleep disorders. Gender, pain intensity, duration, comorbid mental health conditions, and opioid use emerged as modifiable risk factors. Targeted interventions addressing these factors may improve sleep outcomes in individuals with chronic pain.
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Analysis of Risk Factors and The Impact of Nitric Oxide (NO) and Carbon Monoxide (CO) Levels on Lung Function: A Comparative Study of Palm Oil Factory Workers and the Community in Kuantan Mudik District, Riau, Indonesia
Views: 607Downloads: 345Background: Air pollution, particularly from industrial sources like palm oil factories, poses a significant risk to respiratory health. This study aimed to investigate the impact of nitric oxide (NO) and carbon monoxide (CO) exposure on lung function in palm oil factory workers and compare it to the lung function of individuals in the surrounding community.
Methods: A cross-sectional study was conducted in Kuantan Mudik District, Riau, Indonesia. One hundred palm oil factory workers with a minimum of two years of employment and 100 community members not occupationally exposed to NO and CO were recruited. Lung function was assessed using spirometry, and NO and CO levels were measured using specialized analyzers. Participants completed the European Community Respiratory Health Survey (ECRHS) questionnaire, and demographic and clinical data were collected. Statistical analyses included univariate, bivariate, and multivariate logistic regression.
Results: Factory workers exhibited significantly higher levels of NO (p=0.000) and a higher prevalence of restrictive lung function (17%) compared to the community members (3%). Multivariate analysis identified NO exposure as the most significant risk factor for restrictive lung function (p=0.005). Each unit increase in NO was associated with a 1.12-fold increased risk of restrictive lung function. CO exposure, age, gender, smoking history, and the use of personal protective equipment (PPE) were not significantly associated with lung function impairment in this study.
Conclusion: Occupational exposure to NO in palm oil factories is a significant risk factor for restrictive lung function impairment. Regular monitoring of NO levels and the implementation of effective control measures are crucial to protect the respiratory health of palm oil factory workers.
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Relationship between Hyperglycemia and Retinopathy of Prematurity in Very Low Birth Weight Infants: A Systematic Review
Views: 619Downloads: 348Background: Retinopathy of prematurity (ROP) is the major cause of neonatal blindness and may account for up to 10% of juvenile blindness. This systematic review evaluates the relationship between hyperglycemia and ROP in VLBW infants.
Methods: PRISMA guidelines were used to conduct a systematic review using an online database: Google Scholar, PubMed, and the Wiley Online Library. Original research studies examining the association between hyperglycemia and ROP were the inclusion criteria. Animal studies, a letter to the editor, a commentary report, a review, a meta-analysis not available in full text in English or Bahasa Indonesia, and data in the study insufficient for analysis were all excluded.
Results: This systematic review includes nine studies, six cohorts and three case-control studies, involving a total of 1,566 infants. Six studies indicated that newborns in the ROP group had lower mean gestational age and birthweight than those in the non-ROP group. Five investigations found that the mean glucose level in the ROP group was greater than in the non-ROP group. Six studies found that the prevalence of glycemia was much higher than in the non-ROP group. Eight of the nine studies found a significant relationship between hyperglycemia in VLBW infants, and only one found no significant relationship between them. The highest odds ratio and relative risk of hyperglycemia causing ROP were 14.27 (5.16–39.50); p-value <0.001 and 28.062 (7.881–99.924); p-value <0.001, respectively. The overall range of values found across the studies was also considered.
Conclusion: Hyperglycemia has a significant relationship with ROP and is also a risk factor for ROP in VLBW infants.
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Critical Management of Recurrent Seizure at 16-Year-Old Primigravida with Atypical Eclampsia: A Case Report
Views: 581Downloads: 323Background: Atypical eclampsia, characterized by seizures without the classic signs of hypertension and proteinuria, presents a diagnostic and therapeutic challenge in the critical management aspect. This case report highlights the critical management of recurrent seizures in a young primigravida with atypical eclampsia.
Case presentation: A 16-year-old primigravida at 38 weeks gestation presented with recurrent generalized tonic-clonic seizures. Despite initial magnesium sulfate therapy, seizures persisted postpartum. The patient was managed with a combination of midazolam and dexmedetomidine for seizure control and sedation. After five days of intensive care, the patient recovered without further complications.
Conclusion: This case underscores the importance of considering atypical eclampsia in pregnant women presenting with seizures, even in the absence of typical preeclampsia symptoms. The successful use of midazolam and dexmedetomidine in this case suggests their potential as alternative therapeutic agents for refractory seizures in eclampsia. Further research is needed to validate these findings and establish optimal treatment protocols for atypical eclampsia.
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Analysis of Risk Factors and Body Mass Index Against Degrees of Severity of Psoriasis Vulgaris
Views: 615Downloads: 316Background: Psoriasis vulgaris (PV) is a chronic inflammatory skin disease with a multifactorial etiology, including genetic, immunological, and environmental factors. Obesity, characterized by a high body mass index (BMI), has been increasingly recognized as a potential risk factor for PV and may influence its severity. This study aimed to analyze the relationship between various risk factors, particularly BMI, and the severity of PV.
Methods: A cross-sectional study was conducted at a dermatology outpatient clinic of Dr. Moewardi Surakarta Hospital. Patients with a confirmed PV diagnosis were enrolled. Demographic data, medical history, lifestyle factors (smoking, alcohol consumption), and anthropometric measurements (height, weight, BMI) were collected. PV severity was assessed using the psoriasis area and severity index (PASI). Statistical analysis, including univariate and multivariate logistic regression, was performed to identify associations between risk factors and PV severity.
Results: The study included 200 PV patients with a mean age of 45.2 years (SD = 12.8) and a male predominance (58%). The mean PASI score was 12.4 (SD = 8.6), indicating a wide range of disease severity. Multivariate analysis revealed that obesity (BMI ≥ 30 kg/m2) was significantly associated with increased PV severity (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.5-5.2, p = 0.001). Smoking (OR = 1.9, 95% CI = 1.1-3.3, p = 0.02) and a family history of psoriasis (OR = 2.3, 95% CI = 1.3-4.1, p = 0.004) were also identified as independent risk factors for higher PASI scores. Alcohol consumption showed a borderline association with increased severity (OR = 1.6, 95% CI = 1.0-2.6, p = 0.05).
Conclusion: Obesity, smoking, and a family history of psoriasis are significant risk factors for increased PV severity. These findings underscore the importance of addressing modifiable risk factors, such as weight management and smoking cessation, in the holistic management of PV. Further research is warranted to elucidate the underlying mechanisms linking these risk factors to PV severity and to develop targeted interventions to improve patient outcomes.
