Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Relationship between Hyperglycemia and Retinopathy of Prematurity in Very Low Birth Weight Infants: A Systematic Review
Get PDFBackground: 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.
 
Critical Management of Recurrent Seizure at 16-Year-Old Primigravida with Atypical Eclampsia: A Case Report
Get PDFBackground: 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
Analysis of Risk Factors Related to Malnutrition on Length of Stay Hospitalization: A Single-Center Observational Study at Klungkung General Hospital, Indonesia
Get PDFBackground: Malnutrition is a prevalent issue in hospital settings, significantly impacting patient outcomes and healthcare costs. This study aimed to identify and analyze risk factors associated with malnutrition and its influence on the length of stay (LOS) among hospitalized patients at Klungkung General Hospital, Indonesia.
Methods: A retrospective observational study was conducted, including adult patients admitted to Klungkung General Hospital between January 1, 2023, and December 31, 2023. Malnutrition was assessed using the Subjective Global Assessment (SGA) tool. Patient demographics, medical history, nutritional status, laboratory parameters, and LOS were collected. Univariate and multivariate analyses were performed to identify risk factors associated with malnutrition and its impact on LOS.
Results: A total of 43,949 patients were included in the study, with 1,084 (2.46%) identified as malnutrition. The mean LOS for malnutrition patients was significantly longer than for well-nutrition patients (7.8 days vs. 4.2 days, p < 0.001). Multivariate analysis revealed that age ≥ 60 years (OR 2.31, 95% CI 1.85-2.89), presence of comorbidities (OR 1.75, 95% CI 1.42-2.16), low albumin levels (OR 2.05, 95% CI 1.68-2.50), and inadequate dietary intake (OR 1.98, 95% CI 1.61-2.43) were independent risk factors for malnutrition. Malnutrition was also an independent predictor of prolonged LOS (OR 1.68, 95% CI 1.36-2.07).
Conclusion: Malnutrition is a significant problem at Klungkung General Hospital, associated with increased LOS. Early identification of risk factors and implementation of targeted nutritional interventions are crucial to improve patient outcomes and reduce healthcare costs
Risk Factors Associated with Intraocular Pressure and the Correlation of Central Corneal Thickness to Actual Intraocular Pressure in Myopia Patients
Get PDFBackground: Myopia, a prevalent refractive error, is associated with an increased risk of glaucoma, a leading cause of irreversible blindness. Central corneal thickness (CCT) is a key factor in glaucoma assessment, as thinner corneas can lead to underestimation of intraocular pressure (IOP). This study aimed to investigate the correlation between CCT and actual IOP in myopic patients, considering various risk factors that may influence IOP.
Methods: This cross-sectional study included myopic patients aged 20-25 years. Participants underwent comprehensive ophthalmic examinations, including visual acuity assessment, autorefraction, CCT measurement using optical coherence tomography (OCT), and Goldmann applanation tonometry for IOP measurement. IOP values were corrected for CCT. Statistical analysis was performed using ANOVA, Pearson correlation tests, and multivariate regression analysis to identify independent risk factors for elevated IOP.
Results: A total of 78 eyes from 78 participants were analyzed. The mean CCT was significantly thinner in moderate myopia compared to mild myopia and emmetropia (p = 0.000). While IOP was lower in moderate myopia, the actual IOP, after CCT correction, was not significantly different among the groups (p = 0.078). A strong positive correlation was found between CCT and IOP (r = 0.737, p = 0.000), and a moderate negative correlation was observed between CCT and actual IOP (r = -0.492, p = 0.000). Multivariate regression analysis identified axial length (p = 0.021) and family history of glaucoma (p = 0.038) as independent risk factors for elevated IOP.
Conclusion: This study highlights the importance of CCT assessment in myopic patients, as thinner corneas can mask elevated IOP. Regular eye examinations, including CCT and IOP measurements, are crucial for early detection and management of glaucoma in this high-risk population. Axial length and family history of glaucoma were identified as independent risk factors for elevated IOP, emphasizing the need for comprehensive risk assessment in myopic individuals
Molecular Mechanisms of Ozonized Nigella sativa Oil in Wound Repair: Albumin as Biomarker in Rat Model
Get PDFBackground: Wound healing is a complex physiological process that can be impaired in various conditions. Nigella sativa oil, rich in bioactive compounds like thymoquinone, has shown promise in promoting wound healing. Ozone therapy, through the generation of reactive oxygen species (ROS), has also been explored for its potential to accelerate wound repair. This study aimed to investigate the molecular mechanisms underlying the effects of ozonized Nigella sativa oil on wound healing, with a focus on albumin as a biomarker of tissue regeneration in a rat model.
Methods: Full-thickness skin wounds were created on the backs of Sprague Dawley rats. The rats were randomly divided into four groups: a control group receiving no treatment, and three treatment groups receiving topical applications of ozonized Nigella sativa oil at different ozone concentrations (1400 mg/ml, 1800 mg/ml, and 2200 mg/ml) for 7 days. Wound healing was assessed by measuring wound closure rates and histological analysis. Albumin levels in wound tissue were quantified using immunohistochemistry. Additionally, the expression of key genes involved in wound healing, including growth factors, cytokines, and matrix metalloproteinases, was evaluated using quantitative real-time PCR.
Results: Ozonized Nigella sativa oil significantly accelerated wound closure compared to the control group. Histological analysis revealed improved tissue regeneration and collagen deposition in the treated groups. Albumin levels were significantly elevated in the wound tissue of rats treated with ozonized Nigella sativa oil, particularly at the highest ozone concentration. Furthermore, the expression of growth factors (VEGF, TGF-β), pro-inflammatory cytokines (IL-1β, TNF-α), and matrix metalloproteinases (MMP-2, MMP-9) was modulated in a manner consistent with enhanced wound healing.
Conclusion: Ozonized Nigella sativa oil promotes wound healing in a rat model through multiple molecular mechanisms, including the stimulation of albumin synthesis, growth factor expression, and controlled inflammation. These findings suggest that ozonized Nigella sativa oil may have therapeutic potential for enhancing wound repair in clinical settings
Exploring The Interplay of Stunting and Upper Respiratory Infection in Kronjo Health Center: A Cross-Sectional Study
Get PDFBackground: 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
T Cell Dysfunction in Systemic Lupus Erythematosus
Get PDFSystemic 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
Dermoscopy Evaluation of Erythema Dyschromicum Perstans Treated with Combination of Topical Steroid and Narrowband-Ultraviolet B: A Case Report
Get PDFBackground: 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
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
Get PDFBackground: 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
Combination Therapy of Topical Antioxidant Gel and Platelet-Rich Plasma (PRP) in Pyoderma Gangrenosum Ulcer: A Case Report
Get PDFBackground: Pyoderma gangrenosum (PG) is a rare necrotic ulcerative skin disease, often associated with an underlying systemic condition. Bacterial coinfection in PG can worsen the course of the disease and slow healing.
Case presentation: We report the case of a 25-year-old woman with PG of her left leg complicated by Pseudomonas aeruginosa co-infection. The patient had a history of poorly treated psoriasis. The diagnosis is made based on disease history, physical examination, microbiological examination, and histopathological examination. The patient was treated with oral levofloxacin and topical combination therapy of astaxanthin and platelet-rich plasma (PRP) with wound debridement. Significant clinical improvement was achieved within six weeks.
Conclusion: PG with bacterial coinfection requires appropriate diagnosis and treatment to achieve optimal results. Topical therapy combining astaxanthin and PRP with wound debridement proved effective in this case