Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Overview of Characteristics of Parathyroid Tumor Patients at Dr. Hasan Sadikin General Hospital Bandung, Indonesia: A 5-Year Study
Get PDFBackground: Parathyroid tumors are the most common endocrine neoplasms, with hyperparathyroidism as the main clinical manifestation. Parathyroid adenoma is the most common benign neoplasm, while parathyroid carcinoma is relatively rare but difficult to differentiate from benign disorders. This study aims to describe the characteristics of parathyroid tumor patients at Dr. Hasan Sadikin General Hospital (RSHS) Bandung over the last 5 years.
Methods: This descriptive observational research was carried out by collecting medical record data from parathyroid tumor patients at RSHS Bandung for the 2019-2023 period. Parameters identified included age, gender, and histopathological type. Data analysis was carried out using SPSS univariately.
Results: There were 12 patients with parathyroid tumors with an increasing trend in cases over the last 5 years. The average age of patients was 37.33 years, with the majority (9 cases) being women. Parathyroid adenoma was the most common histopathological type (8 cases), followed by parathyroid carcinoma (2 cases), osteitis fibrocystica (1 case), and bone deformity (1 case). One patient with parathyroid adenoma was also diagnosed with fibrous dysplasia.
Conclusion: The majority of cases of parathyroid tumors at RSHS Bandung occur in women, with the incidence of parathyroid carcinoma being the same in men and women. Parathyroid adenoma is the most common histopathological type, and bone abnormalities complications can occur in patients with parathyroid disorders (3 patients)
Effectiveness of Renal Denervation Therapy in Persistent Hypertension: A Meta-Analysis
Get PDFBackground: Persistent hypertension is a global health problem that requires effective therapy. Renal denervation (RDN) therapy is emerging as a promising new option. This meta-analysis aims to evaluate the effectiveness of RDN in patients with persistent hypertension.
Methods: We performed a systematic search in PubMed, Scopus, and the Cochrane Library for studies evaluating the effectiveness of RDN in patients with persistent hypertension. Data were extracted and analyzed using a random effects model.
Results: A total of 12 studies with a total of 1,024 patients were included in this meta-analysis. RDN demonstrated significant reductions in systolic and diastolic blood pressure compared with controls (MD -12.3 mmHg [95% CI -15.8 to -8.8] for systolic blood pressure and MD -6.1 mmHg [95% CI -8.2 to -4.0] for blood pressure diastolic). The effectiveness of RDN is higher in patients with more severe hypertension and in patients who are unresponsive to antihypertensive drugs.
Conclusion: RDN is an effective therapy for persistent hypertension, especially in patients with more severe hypertension and in patients who are unresponsive to antihypertensive drugs
Differences in Average Albumin Levels in Coronavirus Disease 2019 (COVID-19) Survivor and Non-Survivor Patients: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 infection triggers a systemic inflammatory response that can lead to a decrease in serum albumin levels. A more severe inflammatory response in non-survivor COVID-19 patients may correlate with a more significant decrease in albumin levels. This study aims to analyze differences in mean albumin levels in COVID-19 survivors and non-survivors.
Methods: This cross-sectional analytical study involved 40 COVID-19 survivors and non-survivors treated at Dr. M. Djamil General Hospital Padang from July 2021 to September 2021. Serum albumin levels were checked using an automated clinical chemistry tool. Data analysis was carried out using the Mann-Whitney non-parametric test, with a significance level of p < 0.05.
Results: The mean age of the study subjects was 49.4 (16.3) years, with the majority of cases occurring in men (67.5%). The median albumin levels in all COVID-19 patients, COVID-19 survivors, and COVID-19 non-survivors were 3.2 (2.20–5.00) g/dL, respectively; 4.1 (3.0–5.0) g/dL; and 2.9 (2.20–3.70) g/dL (p = 0.001).
Conclusion: There is a significant difference in mean albumin levels between COVID-19 survivors and non-survivors. Lower albumin levels were found in non-survivor patients. Albumin can be a potential biomarker for predicting clinical outcomes of COVID-19 patients
Efficacy of Topical Niacinamide on Skin Hydration of Adolescents with Acne Vulgaris: An Experimental Study on the Adolescent Community in Jakarta, Indonesia
Get PDFBackground: Acne vulgaris (AV) is a chronic inflammatory skin disorder common in adolescents, often accompanied by dry, irritated skin. Topical niacinamide (vitamin B3) has shown potential in increasing skin hydration and reducing AV symptoms. This study aims to evaluate the efficacy of topical niacinamide on skin hydration in adolescents with AV in Jakarta, Indonesia.
Methods: This research is a randomized controlled experimental study involving 100 adolescents (14-19 years) with mild to moderate AV in Jakarta. Participants were randomly divided into two groups: the intervention group (receiving topical 4% niacinamide cream) and the control group (receiving placebo cream). The intervention was carried out for 8 weeks, and skin hydration was measured using a corneometer at baseline, week 4, and week 8. Data analysis was carried out using paired t-tests and independent t-tests.
Results: There was a significant increase in skin hydration in the intervention group compared to the control group at week 4 (p < 0.001) and week 8 (p < 0.001). No significant side effects were reported.
Conclusion: Topical niacinamide was effective in increasing skin hydration in adolescents with AV in Jakarta, Indonesia. This study supports the use of topical niacinamide as an adjunct therapy in the management of AV, especially in adolescents with dry, irritated skin
A Meta-Analysis of Electric Cigarette Use and Lung Health Implications
Get PDFBackground: 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
Ocular Manifestations and Risk Factors of HIV in a Single-Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Human immunodeficiency virus (HIV) infection is associated with various ocular manifestations, impacting visual health and quality of life. This study aimed to investigate the spectrum of ocular manifestations and their associated risk factors in HIV-positive individuals at Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: This single-center observational study included HIV-positive patients presenting with ocular complaints at Dr. M. Djamil General Hospital between 2019 and 2021. Comprehensive ophthalmic examinations were conducted, and data on demographics, HIV disease stage, CD4+ T-cell count, antiretroviral therapy (ART) status, and ocular findings were collected. Statistical analysis was performed to identify associations between risk factors and specific ocular manifestations.
Results: A total of 149 HIV-positive patients were included in the study, with 7 (4.7%) presenting with ocular manifestations. The most common ocular manifestation was cytomegalovirus (CMV) retinitis (57.1%), followed by retinal nerve fiber layer (RNFL) thinning (42.9%). Other manifestations included visual field disturbances and herpes zoster ophthalmicus (HZO). Low CD4+ T-cell count (<200 cells/μL) was significantly associated with CMV retinitis (p < 0.05).
Conclusion: CMV retinitis and RNFL thinning were the predominant ocular manifestations in this HIV-positive cohort. Low CD4+ T-cell count emerged as a significant risk factor for CMV retinitis. Early detection and prompt management of ocular manifestations are crucial to prevent visual impairment in HIV-positive individuals
Matrix Metalloproteinases as Biomarkers for Ischemic Stroke: A Systematic Review
Get PDFBackground: Ischemic stroke, a leading cause of mortality and disability worldwide, occurs due to the disruption of blood flow to the brain, resulting in neuronal damage and death. Matrix metalloproteinases (MMPs), a family of zinc-dependent endopeptidases, play a crucial role in the pathophysiology of ischemic stroke by degrading the extracellular matrix and contributing to blood-brain barrier disruption, inflammation, and neuronal cell death. This systematic review aims to comprehensively evaluate the current evidence regarding the potential of MMPs as biomarkers for ischemic stroke diagnosis, prognosis, and therapeutic monitoring.
Methods: A systematic search of electronic databases (PubMed, Embase, and Cochrane Library) was conducted to identify relevant studies published between 2018 and 2024. Studies investigating the association between MMPs and ischemic stroke in human subjects were included. Data extraction and quality assessment were performed independently by two reviewers.
Results: The search yielded 2,182 articles, of which 8 studies met the inclusion criteria. The included studies evaluated various MMPs, including MMP-2, MMP-3, MMP-9, and MMP-12, in different biological samples (serum, plasma, cerebrospinal fluid, and brain tissue) from ischemic stroke patients. The majority of studies reported elevated levels of MMPs in ischemic stroke patients compared to healthy controls, with MMP-9 being the most extensively studied. Furthermore, several studies demonstrated a correlation between MMP levels and stroke severity, functional outcome, and the risk of hemorrhagic transformation.
Conclusion: The findings of this systematic review suggest that MMPs, particularly MMP-9, hold promise as potential biomarkers for ischemic stroke. However, further research is needed to validate their clinical utility and to explore their potential as therapeutic targets
Rare Presentation of Non-Tuberculous Mycobacteria: A Case of Lung Infection with Pleural Effusion
Get PDFBackground: Non-tuberculous mycobacteria (NTM) are environmental organisms that can cause pulmonary infections, particularly in individuals with predisposing conditions. While NTM lung disease is increasingly recognized, pleural effusion as a complication remains uncommon, posing diagnostic and therapeutic challenges. This case emphasizes the importance of a high index of suspicion, comprehensive microbiological investigations, and bronchoscopy in the diagnosis of NTM lung disease with pleural effusion.
Case presentation: We present the case of a 55-year-old male farmer with a history of smoking, who presented with progressive dyspnea, cough, and constitutional symptoms. Initial investigations suggested tuberculosis, but sputum tests were negative. Chest imaging revealed a right pleural effusion and cavitary lung lesions. Pleural fluid analysis showed an exudative pattern with elevated adenosine deaminase (ADA) but negative for acid-fast bacilli. Bronchoscopy with bronchoalveolar lavage culture yielded Mycobacterium other than tuberculosis (MOTT). The patient was diagnosed with NTM lung disease complicated by pleural effusion and initiated on multidrug therapy.
Conclusion: This case highlights the diagnostic challenges of NTM lung disease, particularly when presenting with pleural effusion. A high index of suspicion, comprehensive microbiological investigations, and bronchoscopy are crucial for accurate diagnosis. Prompt initiation of appropriate multidrug therapy is essential for optimal outcomes
Early-Onset Neonatal Sepsis and Respiratory Distress in a Newborn with Congenital Diaphragmatic Hernia: A Case Report
Get PDFBackground: A congenital diaphragmatic hernia (CDH) is a severe birth defect where abdominal organs protrude into the chest cavity through a hole in the diaphragm, often leading to respiratory distress. Neonates with CDH are also at an increased risk of developing early-onset neonatal sepsis (EOS) due to impaired lung development and immune function. This case report describes the challenges in managing a newborn with CDH who developed EOS and respiratory distress shortly after birth.
Case presentation: A 2-day-old infant presented with respiratory distress, including tachypnea, grunting, and retractions. The infant was born full-term via cesarean section with Apgar scores of 5, 7, and 8 at 1, 5, and 10 minutes, respectively. Physical examination revealed decreased breath sounds, dullness to percussion, and decreased fremitus on the left side of the chest. A chest X-ray showed intestinal gas in the left thoracic cavity, confirming the diagnosis of CDH. Laboratory investigations revealed anemia, thrombocytopenia, neutrophilia, lymphocytopenia, and hypocalcemia, suggesting EOS. The infant was admitted to the neonatal high care unit (HCU) and received respiratory support with continuous positive airway pressure (CPAP) and was kept nil per os (NPO). A laparotomy was planned to repair the diaphragmatic hernia. On day 3, the infant developed signs of sepsis and was started on antibiotics. After stabilization, the infant was transferred to the neonatal intensive care unit (NICU) for definitive surgical repair. Post-operatively, the infant received antibiotics, analgesics, and supportive care.
Conclusion: This case highlights the complexities of managing newborns with CDH and EOS. Early recognition and prompt intervention are crucial for improving outcomes in these critically ill infants
Successful Anesthetic Management for Mandibular Neoplasm Resection in a Patient with Osteogenesis Imperfecta: A Case Report
Get PDFBackground: Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility and deformities. Patients with mandibular neoplasms and suspected OI require careful anesthetic management to avoid complications. This case report describes the successful anesthetic management of a patient with a mandibular neoplasm and suspected OI.
Case presentation: A 33-year-old man presented with a large mandibular tumor causing airway obstruction and difficulty eating. He had physical features suggestive of OI, including short stature, bone deformities, and abnormal tooth growth. Preoperative evaluation revealed a difficult airway due to the tumor and potential cervical spine instability. Anesthesia was induced with propofol and atracurium after securing the airway via ultrasound-guided tracheostomy under local anesthesia. The tumor was resected successfully, and the patient recovered without complications.
Conclusion: Anesthetic management in patients with suspected OI and mandibular neoplasms requires careful planning and execution. A multidisciplinary approach, including preoperative evaluation, airway management strategies, and close postoperative monitoring, is crucial for successful outcomes