Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Efficacy of Metformin in the Prevention and Management of Paclitaxel Chemotherapy-Induced Peripheral Neuropathy: A Systematic Literature Review
Get PDFBackground: 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
The Role of rs6152 Allele and Non-Genetic Factors in Androgenetic Alopecia: A Pilot Study in the Indonesian Local Population
Get PDFBackground: Androgenetic alopecia (AGA) is a common form of hair loss which inflicts progressive hair loss leading to various patterns. The cause of this disease is believed to be multifactorial, which is majorly attributed to genetic and non-genetic factors. This pilot study aimed to investigate the association of rs6152 allele, a SNP on AR gene, with AGA, as well as explore other contributing factors in the Indonesian local population.
Methods: In this cross-sectional study, a total of 100 participants, which categorized into alopecia subjects and non-alopecia subjects, were enrolled for rs6152 SNPs detection. Anthropomorphic data such as height and weight, blood pressure and family history were obtained by measurement and questionnaire.
Results: The study showed low frequency of individuals with rs6152 non-risk alleles (2%) and further analysis showed no significant association between rs6152 allele and AGA. However, familial history analysis revealed a strong association between family history and AGA risks. Additionally, age, gender, hypertension status and BMI were identified as significant factors associated (p-value < 0.05) with AGA.
Conclusion: rs6152 was not a reliable genetic marker for AGA in the Indonesian local population. While familial history with AGA showed the inheritance pattern of autosomal dominant inheritance with sex limitation, non-genetic factors such as age, gender, hypertension status and BMI were strongly associated with AGA risk. This shows the complexity and multifactorial causes of AGA in the Indonesian local population
Primary Breast Angiosarcoma: Serial Cases
Get PDFBackground: Breast angiosarcoma is a rare malignancy arising from endothelial cell lining, approximately 0.04–0.05% of all breast malignancies and less than 1% of all sarcomas. Consisting of primary breast angiosarcoma (PAS) and secondary breast angiosarcoma (SAS). Diagnosis is often delayed because the case is rare and asymptomatic, the lump is painless, grows quickly, progressive disease can develop distant metastasize, and the prognosis is reportedly poor.
Case presentation: This case series presents two cases of primary breast angiosarcoma; the first patient is a patient who needs to obtain a diagnosis through physical examination, imaging, surgery, histopathology, and immunohistochemistry. The second patient is how to reconstruct the surgical defect using the Latissimus dorsi flap, and interestingly, with thirteen years of survival without recurrence, Surgery is the main treatment with high local recurrence. Wide excision in the form of a simple mastectomy is recommended if a tumor-free margin of 2-3 cm cannot be achieved. Tumor excision, or cosmesis, is not achieved, which is related to the proportion of breast and tumor size. The use of radiation therapy and neoadjuvant or adjuvant chemotherapy is still controversial.
Conclusion: Establishing a diagnosis with a thorough examination starts with anamnesis, physical examination, radiological examination, and histopathology, including immunohistochemistry, which is an important examination in confirming the diagnosis
Extramammary Paget's Disease of the Vulva: A Rare Case Report
Get PDFBackground: 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
Anesthetic Management of a Single Ventricle in Pediatric Patient Undergoing Open Duodeno–Duodenostomy Surgery: A Case Report
Get PDFBackground: Duodenal atresia is a rare congenital disorder characterized by blockage of the small intestine. Open duodeno-duodenostomy is the surgery of choice to correct this condition.
Case presentation: We report the case of a three-day-old baby girl with duodenal atresia and a functional single ventricle who underwent open duodeno-duodenostomy. The patient was born via caesarean section due to indications for a previous caesarean section in the mother and congenital abnormalities in the fetus. At birth, the patient showed signs of intestinal obstruction and cyanosis. Preoperative physical and laboratory examinations confirmed duodenal atresia and cardiac abnormalities. The patient underwent an open duodeno-duodenostomy without complications. The patent ductus arteriosus must be kept open to maintain systemic perfusion by maintaining PaO2 at 40 to 45 mmHg and SaO2 at 70% to 80%, along with the administration of prostaglandin agents. Good perioperative management and improvements in surgical procedures will increase the life expectancy of patients with single ventricle problems, especially hypoplastic left heart syndrome. The use of low-dose fentanyl induction agent, 1 MAC sevoflurane, and atracurium has been proven to produce favorable outcomes in these patients.
Conclusion: Open duodeno-duodenostomy is a safe and effective operation for duodenal atresia. The patient in this case recovered well after surgery. Open duodeno-duodenostomy should be considered as the primary treatment option for duodenal atresia
Study Analysis of Total Bilirubin Levels on Mortality in COVID-19 Patients: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Coronavirus Disease 2019 (COVID-19) is caused by a positive single-stranded RNA virus. The clinical manifestations of COVID-19 are not only dominated by respiratory tract symptoms but can also show symptoms of liver damage in severe COVID-19 patients. Liver damage that occurs can cause acute liver failure and result in death. Examination of liver damage marker parameters such as total bilirubin needs to be carried out as mortality increases in COVID-19 patients. This study aims to determine the relationship between total bilirubin levels and mortality in COVID-19 patients.
Methods: Cross-sectional analytical research was conducted on 40 COVID-19 patients treated at Dr. M. Djamil General Hospital Padang from July to December 2021. Examination of total bilirubin levels using the colorimetric diazo method. Bivariate analysis used the Mann-Whitney test to see the relationship between total bilirubin levels and mortality.
Results: The average age of the research subjects was 61.85 (1.40) years, with 65% men and 35% women. The mortality percentage in COVID-19 patients is 65%. The median total bilirubin level was 1.95 (0.5-2.8) mg/dL. The relationship between total bilirubin levels and mortality in COVID-19 patients was found to have a p-value of <0.001. The study results showed that the median total bilirubin level in COVID-19 patients who died was relatively higher, namely 2.20 (1.4-2.8) mg/dL, compared to those who did not die, namely 0.70 (0.5-1. 6) mg/dL.
Conclusion: The results of this study show that there is a relationship between total bilirubin levels and mortality in COVID-19 patients
Analysis of the Role of Vitamin C Hypovitaminosis in Scurvy on Bone Health: A Single Center Observational Study at Dr. Moewardi General Hospital, Surakarta, Indonesia
Get PDFBackground: Scurvy, vitamin C deficiency, is a rare condition but remains relevant in Indonesia. This study aims to analyze the role of vitamin C hypovitaminosis in the development of scurvy and its impact on bone health through an observational study at Dr. Moewardi General Hospital. Surakarta.
Methods: A cross-sectional observational study was conducted on 30 patients diagnosed with scurvy at Dr. Moewardi General Hospital Surakarta during the 2020-2023 period. Demographic data, medical history, nutritional status, and severity of scurvy were collected. A radiological examination of the bone is performed to assess scurvy-related changes. Descriptive, comparative, and Spearman correlation statistical analyzes were used.
Results: The majority of patients were men (66.7%) with a mean age of 45 years. A history of an unbalanced diet with low fruit and vegetable intake was found in the majority of patients (86.7%). Common symptoms include fatigue (86.7%), joint pain (73.3%), bleeding gums (60%), and skin bleeding (53.3%). The severity of scurvy varied, with 10 patients (33.3%) experiencing severe scurvy. Radiological examination shows significant changes in long bones, especially osteoporosis and thinning of the cortex, which is more obvious in patients with severe scurvy. Spearman correlation analysis showed a positive correlation between the severity of scurvy and the incidence of osteoporosis (rho = 0.495, p = 0.005) and cortical thinning (rho = 0.394, p = 0.031).
Conclusion: Vitamin C hypovitaminosis plays a significant role in the development of scurvy and has a negative impact on bone health. Early screening and diagnosis of scurvy are important to prevent musculoskeletal complications. Nutritional education and dietary interventions to increase vitamin C intake need to be intensified, especially in high-risk groups
Screening and Identification of Erythrocyte Antibodies: A Narrative Literature Review
Get PDFRed 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
Serum Uric Acid and Nitric Oxide Levels in Relation to Coronary Artery Occlusion Severity in STEMI (ST Elevation Myocardial Infarct): A Meta-Analysis
Get PDFBackground: 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
Risk Factors for Sleep Disorders in Patients with Chronic Pain: A Meta-Analysis
Get PDFBackground: 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