Bioscientia Medicina - Journal of Biomedicine and Translational Research
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A Rare Case of Juvenile Xanthogranuloma in 8 Months Old Baby with Dyslipidemia
Get PDFBackground: Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis disease of childhood. But due to rarity of non Langerhans cell hystiosis itself, the exact prevalence of juvenile xanthogranuloma remain unknown with only a few epidemiological journal ever published. Juvenile xanthogranuloma usually wihout lipid abnormality and systemic involvement. But association between JXG and lipid abnormalities is still not well understood. We describe a patient with multiple cutaneous JXG who also developed hyperlipidemia.
Case: A case of a 8 months-old baby patient with juvenile xanthogranuloma is reported. Patient parents noticed yellowish dots on child’s face since six months ago, and it was gradually increase in size and number, and spread to trunks, upper and lower limb since 2 months ago. Patients got formula milk since 7 months ago. Patients father has uncontrolled hypercholesterolemia, and grandparents had controlled dyslipidemia. Dermatological state showed yellowish plaque and papule on the face, trunk, lower limb, and upper limb. Dermoscopy show yellowish papule with sun setting appearance and branched and linear vessel on orange yellow background. Laboratory finding showed elevated lipid serum. Foam cell and Touton giant cell is found on histopathology examination.
Discussion: The presented case demonstrates that skin lesions in patients with diagnosed JXG may have a variable clinical presentation, ranging from single to diffuse skin lesions, also present from the birth to childhood. The diagnosis requires histopathological confirmation to avoid misdiagnosis of malignant disease. Association between JXG and lipid abnormalities remain unknown, with most of the patient show normal lipid serum. Majority of patients presenting lesions limited to the skin requires only a strict dermatological observation
Accuracy of Cell-Free DNA (cfDNA) in Colorectal Cancer Diagnosis
Get PDFBackground: Colorectal cancer is the third most common type of cancer following lung and breast cancer with the second most common cause of cancer-related death globally. Delayed diagnosis due to limited source and modality to perform early diagnosis lead to advanced-stage condition which contributes to higher morbidities and mortalities. Recent diagnosis of colorectal cancer depends on biopsy of suspected tissues, either obtained surgically or per colonoscopy. Colorectal cancer detection through cell-free DNA measurement allowing small-size cancer being detected even in early stage. cfDNA originated from derivates of increased and abnormality apoptosis-necrosis pathway from cancer lesion, therefore can be managed as specific tumor marker.
Methods: Diagnostic test was performed at the Gastroentero Hepatology Outpatient Unit and Internal Medicine Inpatient Unit of Dr. Mohammad Hoesin General Hospital Palembang from March to June 2021. Data processing and analysis using SPSS version 26.0 for Windows.
Results: Among 50 subjects included, 39 subjects (78%) are diagnosed with colorectal cancer, whereas 11 subjects (22%) as control. The median of cfDNA result is 59,71 ng/mL with 92,3% sensitivity, 90,9% specificity, 95,2% positive predictive value, 82,3% negative predictive value, and 92,4% accuracy rate. Combination the measurement of cfDNA, CEA, and CA19-9 appears to have better AUC instead of single measurement.
Conclusion: The study reveals that cell-free DNA (cfDNA) demonstrated a very promising accuracy rate in diagnosing colorectal cancer
Risk Factors of Catheter-Related Infection in Patients Undergoing Hemodialysis Using Double Lumen Catheter at Dr. M. Djamil Hospital Padang
Get PDFBackground. Chronic kidney disease (CKD) is a terminal disease requiring hemodialysis. Hemodialysis requires vascular access using a double lumen catheter (DLC). However, the use of DLC may increase complications mainly infection, either infection of exit site or bloodstream. This study is aimed to seek risk factors contributing to the incidence of central catheter-related infections in CKD patients with DLC undergoing HD at Dr. M. Djamil Hospital, Padang.
Methods. This study is a prospective study on patients undergoing HD at Dr. M. Djamil Hospital, Padang. This study using consecutive sampling technique. Data were analyzed using SPSS version 25.0.
Results. This study involved 40 CKD patients undergoing HD. Majority of the samples had bloodstream infections (67.5%). Clinical manifestations of purulent secretion, duration of catheter used, and hypoalbuminemia had significant differences in the incidence of DLC infection based on bloodstream infection and exit site infection (p<0.05). The most common bacterial found was Pseudomonas aeruginosa (22.5%) which was sensitive to ceftazidime, cefepime, meropenem, amikacin, gentamicin, ciprofloxacin.
Conclusion. Factors contributing to the incidence of DLC-related infections at Dr. M. Djamil Hospital are duration of catheter use and hypoalbuminemia. Pseudomonas aeruginosa is the most common cause of DLC-related infections
Relationship between Radiological Severity, Knee Pain and Functional Limitation in Patients With Knee Osteoarthritis at Dr. M. Djamil Padang General Hospital
Get PDFBackground: Osteoarthritis (OA) is a degenerative joint disease frequently affecting the elderly and the middle class due to injury or overuse of the joints. An individual with pain due to OA will experience dysfunction of joints and muscles, thus causing movement limitation, decrease of muscle strength and balance. The objective of this study is to know the association of OA radiological degree with pain intensity and limitation of physical capability in patients with knee joint OA.
Methods: This study is a retrospective study on patients with knee joint OA treated at RSUP Dr. M. Djamil Padang in year 2021 from January 2021 to May 2021. Data collection was conducted in the Medical Records Department of RSUP Dr. M. Djamil Padang and questionnaire which fulfills the inclusion and exclusion criteria.
Results: A total of 58 patients fulfilled the inclusion criteria of this study. Results of the study showed the mean age of the respondents was 60 years with variance of 7 years. More than a half (77.6%) of the respondents were female and most common ethnicity was Minang (82.8%). 50% of the patients were housewives. BMI of the respondents were mostly overweight - obese (65.5%). Most commonly affected side of the knee joint OA was the right side (55.2%). Most common degree of OA was the fourth degree (39.7%). More than a half of the respondents (84.5%) had moderate intensity of pain and 34.5% respondents had mild physical limitation. Results of the study showed that there was an association between OA radiological degree and pain intensity in patients with knee joint OA (p value = 0.0001). Results of the study showed that there was an association between OA radiological degree and level of physical capability limitations in patients with knee joint OA (p value = 0.0001). Results of the study showed that there was an association between pain intensity and level of physical capability limitations in patients with knee joint OA (p value = 0.0001).
Conclusion: There was an association between OA radiological degree and pain intensity, physical limitations in patients with knee joint OA, and there was an association between pain intensity and level of physical capability limitation in patients with knee joint OA
A Study Demographic, Histopathological Patterns and Clinical Profile of Oral Squamous Cell Carcinoma in East Java, Indonesia: A Hospital-Based Study
Get PDFBackground. Cancer remains a health problem in the world. Estimated 12,7 million new case and 7,6 deaths cause of cancer each year. Oral carcinoma is one of head and neck carcinoma. Oral carcinoma is 6th the most cancer in the world and 90% of the cases are squamous cell carcinoma. The purpose of this research is to study the clinic-epidemiological profile among Indonesian patients associated with oral cancer cases managed in Head and Neck Surgery Unit of Dr Soetomo General Hospital between January 2013- December 2016.Methods. Records of 116 cases were reviewed for clinical details, histopathological data, and follow-up status. Study variables included demographic factor, modifiable risk factors such as tobacco usage and alcohol consumption, site involved, staging, histopathological result, and treatment modalities. Data was presented in form of percentages and proportions.Results. Out of the total 116 cases, majority of the subjects were above 40 years old. Twenty-two (22%) of subjects were young adult (below 40 years old). Seventy-seven subjects (77 %) were male. It was observed that 16 cases (21%) of male subjects was a smoker before they had disease. No female subject consumed tobacco in all form or drinking alcohol. The most common site involved was tongue, followed by lower ginggivo-buccal complex. Histopathologically, 110 cases (95%) was well-differentiated squamous cell carcinoma. Most of the cases (88.8 %) were in advanced stage (stage III or IV) and were treated with surgery followed by adjuvant therapy.Conclusions. The most common site for oral cancer was tongue and majority of the cases were well-differentiated squamous cancer presented in advanced stage of disease. We observed that alcohol consumption and smoking did not have any role in causing oral cancer in women, therefore further study needed to evaluate other possible factors such as diet pattern and oral hygiene. Cigarette smoking might be the cause of oral cancer in male patients
Factors Related To Outcome of Traumatic Brain Injury Patients at M Djamil Padang Hospital
Get PDFBackground: Traumatic brain injury is still a major threat because it can cause global morbidity and mortality. Many factors can affect the outcome of a traumatic brain injury. Some conditions that can exacerbate traumatic brain injury include GCS conditions, blood pressure variability, and pupillary reflexes.Methods: The research was conducted in M. Djamil Padang Hospital from October 2020 to March 2021. The study design was a cross-sectional study in traumatic brain injury patients with ≤ 48 hours of onset and the aged between 18-60 years. The subjects in this study consisted of 66 subjects. At 6 weeks after onset, a GOS assessment was performed to assess patient outcomes. Statistical analysis was performed computerized with SPSS 22.0. P-value <0.05 was considered statistically significant. Results: Most of the patients were male (71.2%) with an average age of 36.41 ± 14,275 years, and the most common injury mechanism was traffic accidents (95.5%). There was a significant relationship between onset of incidence, hypotension, pupillary reflexes, and Rotterdam score with the outcome of traumatic brain injury patients (p<0.05) and there was no significant relationship between age, gender, and mechanism of injury with the outcome patients with traumatic brain injury. Conclution: The onset of events, hypotension, pupillary reflexes, and Rotterdam scores significantly affect the outcome patients of traumatic brain injury
Zinc Serum Maternal Levels as a Risk Factor for Preeclampsia
Get PDFBackground. Preeclampsia is defined as gestational hypertension and proteinuria which can be measured by the elevation of liver transaminases to twice normal concentration, and the symptoms of increased intracranial pressure such as dizziness, blurred vision, and seizures. Zinc is an essential mineral for many biological functions and one of the trace elements that is directly involved in the oxidative/antioxidant balance, a pathogenesis process in preeclampsia that is highly dependent on dietary habits and supplements. This study was aimed to assess the association between serum zinc level with preeclampsia (PE).
Methods: This observational, case-control study was performed on 90 women with singleton pregnancies at 28 to 42 weeks of gestation which were referred to the Department of Obstetrics and Gynecology, Dr. Mohammad Hoesin General Hospital, Palembang, between August 2020 to November 2020. 30 pregnant women with PE were selected as cases and 60 healthy pregnant women were selected as controls. Maternal serum zinc samples were collected. The collected data were entered into the master table. Tabulation, coding, and statistical data analysis were performed using SPSS version 20.0 for Windows.
Results: The mean serum zinc levels in the case group and control group were 43,90 ± 15,79 µg/dL (ranged from 15 to 86 µg/dL) and 48,77 ± 10,54 µg/dL (ranged from 22 to 83 µg/dL), respectively. A value of serum zinc levels with the best sensitivity and specificity was 45,5 µg/dL.
Conclusion: There was a significant association between maternal serum zinc level with PE. The risk of PE was 3,2 times higher in pregnant women with serum zinc levels of ≤45,5 mcg/dL compared to pregnant women with serum zinc levels of >45,5 mcg/dL. In this case it is necessary to supplement zinc earlier in pregnancy to reduce the risk of preeclampsia
Recurrence Prediction Score of the Localy Advance Breast Cancer in West Sumatera Province, Indonesia
Get PDFIntroduction: Breast cancer is the most common malignancy that occurs in women in the world, which is about 18% of cancer cases that occur in women. Every year there are 1 million new cases of breast cancer worldwide and nearly 60,000 patients die from this disease. Therefore, the authors want to find out more about the prognosis factors that play a role in influencing the survival of patients with locally advanced breast cancer in Padang city, West Sumatera Province Indonesia.
Methods: This study is a retrospective case-control study of locally advanced breast cancer for patients in Padang city. The study was conducted at the Surgical Oncology Division of Dr. M Djamil Padang Hospital, Ropana Suri Hospital, Ibnu Sina Hospital and Siti Rahmah Padang Hospital from September 2018 to December 2018. The total number of samples for the two groups was 242 people. The sampling technique used was convenience sampling.
Results: In this study 4 prognostic factors were found that had a significant effect on predicting breast cancer recurrence, namely histopathological type, stage, regional lymph and lymphovascular invasion with p <0.05.
Conclusion: Prognosis factors that influence breast cancer recurrence are histopathological type, stage, regional lymph node status and lymphovascular invasion. A scoring system is obtained that is good enough to predict the possibility of breast cancer recurrence
Human Papilloma Virus: Biomolecular Aspect
Get PDFHPV is a sexually transmitted virus, and high-risk HPV DNA was found in 99.7%of cervical cancer specimens. Within 12 to 24 months of exposure to the virus,90% of HPV infections disappear or become inactive. However, infection with high-risk strains of HPV persist which then increases the risk of progression to cervicalcancer. The detection of precancerous lesions consists of various methods,including pap smear (conventional or liquid-base cytology / LBC), visualinspection of acetic acid (IVA), visual inspection of lugoliodine (VILI), and HPV DNAtest (genotyping / hybrid capture)
Comparison of Short-Chain Fatty Acid (SCFA) and Interleukin-10 (IL-10) Levels in Patients with Systemic Lupus Erythematosus (SLE) Compared to Healthy Populations at RSUP Dr. Mohammad Hoesin Palembang
Get PDFBackground. Systemic lupus erythematosus (SLE) is a prototypical autoimmune disease with various significant diseases, where SLE can affect the entire population in the world. This study aims to compare and analyze differences in the composition of the gut microbiota of SLE patients compared to healthy controls based on SCFA examination in Indonesia.
Methods. The type of research conducted in this research is an analytical observational study with a case-control design. The research was conducted at Dr. RSUP. Mohammad Hoesin Palembang from October 2020 to October 2021. The sample in this study was divided into two groups, namely, the case group, and the control group. The case group was all SLE patients who met the inclusion criteria, while the control group was a healthy population who did a medical check-up at Dr. RSUP. Mohammad Hoesin Palembang. SCFA examination was carried out using Gas Chromatography-Mass Spectrometry (GCMS) from fecal samples.
Results. The results showed that there were two groups of SCFA values, namely the normal group and the microbiota dysbiosis group where the SCFA value was low or less than 4. in the SLE and normal populations where there were 6 SLE subjects who had normal SCFA values or 37.5% and there were 10 SLE subjects who experienced microbiota dysbiosis. or 62.5%. In the healthy population group, all subjects had SCFA values that were included in the normal category, namely 16 subjects or 100%. Based on the severity of SLE using the SLEDAI MEX score, all SLE patients in the study were in the active or category flare where the SLEDAI MEX score was > 5.
Conclusion. Patients with microbiota dysbiosis tended to have an LES of 7,222 or 7 times greater than patients who did not have microbiota dysbiosis or had normal SCFA values