Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Effectiveness of Vitamin D Supplementation in Reducing Atopic Dermatitis Severity in Children: A Meta-Analysis
Get PDFBackground: Atopic dermatitis (AD) is a chronic inflammatory skin disease that commonly affects children, with increasing prevalence worldwide. Vitamin D has demonstrated immunomodulatory effects, suggesting a potential role in AD management. This meta-analysis aimed to evaluate the effectiveness of vitamin D supplementation in reducing AD severity in children.
Methods: A systematic search of PubMed, Science Direct, and Cochrane databases was conducted for randomized controlled trials (RCTs) published between 2012 and 2024, investigating the effects of vitamin D supplementation on AD in children. The primary outcome was the change in SCORAD (SCORing Atopic Dermatitis) or EASI (Eczema Area and Severity Index) scores. Meta-analysis was performed using Review Manager (RevMan 5.4) software.
Results: Four RCTs met the inclusion criteria, comprising a total of 234 participants. The meta-analysis revealed a significant reduction in SCORAD scores (-2.83; 95% CI: -4.9, -0.76) and EASI scores (-0.41; 95% CI: -0.70, -0.13) in the vitamin D supplementation groups compared to the control groups. A combined analysis of both scoring systems further confirmed the overall significant effect of vitamin D in reducing AD severity (-1.57; 95% CI: -2.78, -0.36).
Conclusion: Vitamin D supplementation is effective in improving AD symptoms in children. Further large-scale RCTs are warranted to determine the optimal dosage and duration of vitamin D supplementation for AD management in children
Behçet's Syndrome Treatment: A Meta-Analysis Comparing Efficacy and Safety of Immunosuppressants and Biologics
Get PDFBackground: Behçet's syndrome (BS) is a chronic inflammatory disorder characterized by recurrent oral and genital ulcers, uveitis, and skin lesions. Immunosuppressants and biologics are commonly used to manage BS, but their comparative efficacy and safety remain unclear.
Methods: A systematic literature search was conducted in PubMed, Embase, and Cochrane Library databases from January 2013 to October 2024. Randomized controlled trials (RCTs) comparing immunosuppressants (azathioprine) and biologics (TNF-alpha inhibitors - infliximab, adalimumab, etanercept) in adult BS patients were included. The primary outcomes were clinical response rates (defined as improvement in disease activity scores) and adverse events. A random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs).
Results: Six RCTs (n=785 patients) met the inclusion criteria. Biologics demonstrated significantly higher clinical response rates compared to immunosuppressants (OR 4.57, 95% CI 3.26-6.40, p<0.00001). Infliximab, adalimumab, and etanercept showed superiority over azathioprine (OR 4.40, 95% CI 2.33-8.30, p<0.00001; OR 5.51, 95% CI 2.86-10.61, p<0.00001; OR 4.19, 95% CI 2.54-6.92, p<0.00001, respectively). Adverse events were comparable between groups, with no significant difference in serious infections or malignancies.
Conclusion: Biologics, particularly TNF-alpha inhibitors, are more efficacious than conventional immunosuppressants in inducing clinical response in BS, with similar safety profiles. These findings support the use of biologics as a first-line treatment option for moderate-to-severe BS
Inflammatory Response in Stroke: A Comparative Leukocyte Analysis in Hemorrhagic and Ischemic Stroke Patients at a Single Center in Jambi, Indonesia
Get PDFBackground: Stroke remains a leading cause of mortality and morbidity worldwide. Inflammation plays a crucial role in the pathophysiology of both hemorrhagic and ischemic stroke. This study aimed to compare total leukocyte counts (TLC) in hemorrhagic and ischemic stroke patients to assess the inflammatory response and its potential implications for clinical outcomes.
Methods: This retrospective study analyzed 74 stroke patients admitted to Abdul Manap Regional Hospital, Jambi, Indonesia, between January 2023 and December 2023. Patients were categorized into hemorrhagic (intracerebral hemorrhage) and ischemic stroke groups based on neuroimaging findings (CT scan or MRI). Demographic data, stroke severity (NIHSS score), and TLC obtained within 24 hours of admission were recorded. Independent t-tests and Mann-Whitney U tests were used for statistical analysis.
Results: The study included 38 ischemic and 36 hemorrhagic stroke patients. The mean TLC was significantly higher in the hemorrhagic stroke group (11.4 ± 3.5 x10^9/L) compared to the ischemic stroke group (9.5 ± 2.8 x10^9/L) (p = 0.021). No significant correlation was found between TLC and stroke severity (NIHSS score) in either group.
Conclusion: Hemorrhagic stroke patients exhibited a more pronounced early inflammatory response as evidenced by elevated TLC compared to ischemic stroke patients. Further research is needed to explore the prognostic value of TLC and the potential role of anti-inflammatory therapies in stroke management
Advantages of Using an Air Purifier for the Control of Atopic Dermatitis
Get PDFNumerous studies have been carried out to ascertain the detrimental impact of air pollution on allergy conditions such as asthma, allergic rhinitis, and atopic dermatitis. Substandard indoor air quality exacerbates atopic dermatitis, which can be attributed to several reasons. Proper air circulation is crucial in households, especially in areas with high foot activity, since it can lead to elevated amounts of air contaminants entering the space. Indoor air pollutants, such as house dust mites, volatile chemical compounds, particle matter, and indoor mold, can aggravate atopic dermatitis. An air purifier effectively enhances the quality of indoor air. This gadget offers significant advantages for those with atopic dermatitis by effectively mitigating the frequency and intensity of disease relapses
Accuracy of Fat Mass and Muscle Mass Measured by Bioelectrical Impedance Analysis in Predicting Osteoporosis in Older Adults
Get PDFBackground: Osteoporosis is a prevalent bone disease characterized by reduced bone mineral density (BMD) and increased fracture risk. This study aimed to evaluate the accuracy of fat mass (FM) and muscle mass measured by bioelectrical impedance analysis (BIA) in predicting osteoporosis in older adults.
Methods: A cross-sectional study was conducted on 109 outpatients aged 60 years and older. FM parameters (total fat mass, visceral fat level, and fat mass index [FMI]) and muscle mass parameters (total muscle mass, appendicular skeletal muscle mass [ASM], and appendicular skeletal muscle mass index [ASMI]) were measured using BIA. Osteoporosis was diagnosed based on BMD measurements using dual-energy X-ray absorptiometry (DXA). Receiver operating characteristic (ROC) curves were used to determine cut-off points and assess the accuracy of BIA parameters in predicting osteoporosis.
Results: The prevalence of osteoporosis was 52.3% (n=57). The optimal cut-off points for predicting osteoporosis were: total fat mass >36.25%, visceral fat level >12.05, FMI >7.82 kg/m2, total muscle mass <37.82 kg, ASM <16.795 kg, and ASMI <6.895 kg/m2. Among the FM parameters, visceral fat level had the highest accuracy (AUC = 60.9%, sensitivity = 64.9%, specificity = 78.8%) while FMI had the lowest (AUC = 53.5%, sensitivity = 56.1%, specificity = 57.7%). For muscle mass parameters, ASM showed the highest accuracy (AUC = 74.0%, sensitivity = 70.2%, specificity = 76.9%).
Conclusion: BIA-derived FM and muscle mass parameters, particularly visceral fat level and ASM can be used to predict osteoporosis in older adults with good accuracy. This non-invasive and accessible method may be useful as a screening tool for osteoporosis, especially in settings where DXA is unavailable
Prevalence and Risk Factors of Sexually Transmitted Infections in a Tertiary Hospital in Surakarta, Indonesia
Get PDFBackground: Sexually transmitted infections (STIs) remain a significant public health concern globally, with millions of new cases occurring annually. Understanding the prevalence and risk factors associated with STIs is crucial for effective prevention and control programs. This study aimed to investigate the prevalence and risk factors of STIs among patients attending the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi General Hospital, a tertiary hospital in Surakarta, Indonesia.
Methods: A retrospective descriptive study was conducted using secondary data from medical records of patients diagnosed with STIs between January 2020 and December 2023. Data collected included sociodemographic characteristics, sexual behaviors, clinical diagnoses, and HIV status. Descriptive statistics and chi-square analysis were used to analyze the data.
Results: A total of 249 patients were diagnosed with STIs during the study period. The most common STI was condyloma acuminata (51%), followed by male genital discharge (18.1%), female vaginal discharge (16%), other STIs (10.9%), and genital ulcers (4%). The majority of patients were male (62.2%), aged 25-44 years (49.1%), had a high school education (49.5%), and reported heterosexual orientation (67.1%). Multiple sexual partners were reported by 62.7% of the participants, and 36.1% were HIV positive. The correlation analysis reveals that various sociodemographic, behavioral, and health-related factors are associated with different STIs.
Conclusion: Condyloma acuminata was the most prevalent STI among patients attending the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi General Hospital. The correlation analysis reveals that various sociodemographic, behavioral, and health-related factors are associated with different STIs. Understanding these correlations can help healthcare providers identify individuals at higher risk for specific STIs and implement targeted prevention and intervention strategies. Targeted interventions focusing on these high-risk groups are needed to reduce the burden of STIs in Surakarta, Indonesia
Successful Epidural Anesthesia Management in Cesarean Section for a Patient with Eisenmenger Syndrome: A Case Report
Get PDFBackground: Eisenmenger syndrome is a rare and complex condition that poses significant challenges for anesthesiologists during pregnancy, particularly during labor and delivery. The physiological changes associated with pregnancy, such as increased cardiac output and blood volume, can exacerbate the hemodynamic instability in these patients. Careful selection of anesthetic techniques and agents is crucial to maintain hemodynamic stability and ensure the safety of both mother and fetus.
Case presentation: We present the case of a 34-35-week pregnant woman with Eisenmenger syndrome who underwent a successful cesarean section under epidural anesthesia. The patient's hemodynamic parameters were closely monitored throughout the procedure, and no significant complications were encountered.
Conclusion: This case report demonstrates that epidural anesthesia can be a safe and effective option for cesarean section in patients with Eisenmenger syndrome. Meticulous planning, close monitoring, and prompt management of potential complications are essential for a successful outcome
Unraveling the Link between Obesity and Tuberculosis: A Systematic Review of the Underlying Mechanisms
Get PDFBackground: Tuberculosis (TB) and obesity are significant global health concerns with potentially complex interactions. Obesity, through its effects on metabolism, inflammation, and the immune system, may influence TB susceptibility, progression, and treatment outcomes. This systematic review aims to analyze the published literature on the relationship between obesity and TB, focusing on the underlying mechanisms.
Methods: A systematic search of PubMed, Science Direct, and Google Scholar was conducted for articles published in the last 10 years. The search strategy included keywords such as "tuberculosis," "TB," "obesity," and "BMI." Articles were selected using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method.
Results: The review identified 11 studies that met the inclusion criteria. The studies revealed a complex relationship between obesity and TB, with nutritional status, immunity, and diabetes mellitus (DM) playing key roles. Obesity can alter the immune response to TB, potentially increasing the risk of disease and affecting treatment efficacy.
Conclusion: The relationship between obesity and TB is multifaceted, with obesity potentially influencing both disease susceptibility and outcomes. Further research is needed to fully elucidate the underlying mechanisms and to develop targeted interventions for individuals with both obesity and TB
Pectoralis Major Flap: A Versatile Option for Head and Neck Reconstruction - A Case Report
Get PDFBackground: Skin flaps are an essential tool in reconstructive surgery, especially in the head and neck region where defects can result from tumor excision, trauma, or congenital anomalies. The pectoralis major flap is a well-established and versatile option for head and neck reconstruction due to its reliable vascularity, ease of harvest, and ability to cover a variety of defect sizes and locations.
Case presentation: This report describes the case of a 22-year-old male with a history of parotid cancer who presented with a large, bleeding mass on the right side of his neck. Following tumor excision, the resulting defect was successfully reconstructed using a pectoralis major flap.
Conclusion: The pectoralis major flap is a reliable and versatile reconstructive option for head and neck defects. It offers several advantages, including good vascularity, ease of harvest, and the ability to provide adequate tissue bulk for complex reconstructions
Successful Steroid Treatment of Extrahepatic Cholestasis: A Case Report
Get PDFBackground: Biliary atresia is the most common cause of cholestasis. However, not all healthcare facilities are capable of performing Kasai surgery and liver transplantation. The involvement of inflammatory processes in the bile ducts triggered by viral infections has been suggested in several theories of pathogenesis. This case report describes the successful steroid treatment of an infant with extrahepatic cholestasis.
Case presentation: A girl aged 2 months and 20 days presented with complaints of jaundice since the age of 2 weeks, with no improvement and worsening of the jaundice, with the color of the stools becoming paler than before. The nutritional status is normal. The physical examination revealed icteric sclera, hepatomegaly, and splenomegaly. There was cholestasis (total bilirubin 7.30 mg/dL and direct bilirubin 5.75 mg/dL), as well as elevated levels of AST (249 U/L), ALT (251 U/L), GGT (995.7 U/L) and increased to 1529.6 U/L, CMV reactive IgG 28.9, and Rubella reactive IgG 6.90. A two-phase ultrasound of the abdomen showed a thickening of the gallbladder wall. A liver biopsy showed mild portal fibrosis (F1). Steroids at a dose of 2 mg/kg/day in combination with ursodeoxycholic acid were administered. At follow-up one month later, the jaundice had improved. Stools were yellow-brown, and liver function tests and bilirubin were normal.
Conclusion: Adjunctive steroid therapy to suppress the inflammatory process in biliary obstruction may be beneficial in the early phase of the disease, especially in limited surgical and transplant settings