Bioscientia Medicina - Journal of Biomedicine and Translational Research
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The Complexities of Colorectal Cancer: A Case Report
Get PDFBackground: Colorectal cancer (CRC) is a malignancy that originates from the colon tissue (ascending, transverse, descending, sigmoid colon) and rectal tissue. Colorectal cancer is the fourth most common cancer in the world, and the second leading cause of cancer death. In Indonesia (2020), colorectal cancer was ranked sixth of the all malignancy diagnoses with a total of 17,368 new cases (4,4%).
Case presentation: a case of colon cancer (mucinous adenocarcinoma) in a 70 year old woman. Diagnosis was based on anamnesis of the presence onf intermitten abdominal pain, a mass in the right iliac region of the abdomen, and defecation accompanied by blood. On physical examination, there was tenderness and a mass in the right iliac region, and a positive Carnett’s sign. computer tomography (CT) of the urinary tract without contrast was performed and revealed a mass was found in the right abdomen, suspicious for the ascending colon and hepatic flexure of the colon, a cyst with a diameter of ± 3cm in the right kidney.
Conclusion: Anatomical patology (microscopic) results showed mucinous adenocarcinoma. The treatment for this patient was exploratory laparotomy, right hemicolectomy, and end to end anastomosis.
 
Parathyroid Adenoma with Multiple Bone Fractures: A Case Report
Get PDFBackground: Parathyroid adenoma is a benign neoplasm of the parathyroid glands and can result in hypercalcemia due to excessive secretion of parathyroid hormone (PTH). This elevated PTH can have various manifestations, including bone fractures.
Case presentation: We report the case of Tn. AB is a 41-year-old man with a series of recurrent bone fractures following minor traumas. Within a span of three years, he suffered from fractures in the right femur, left femur, and left humerus, which led to multiple surgeries, including total hip replacements. Further assessments showed an increased level of PTH and a suspicious lesion in the neck region. A CT scan revealed a potential parathyroid adenoma in the peritracheal region of the right side. Moreover, a Sestamibi scan confirmed an adenoma in the postero-inferior lobe of the right thyroid, consistent with Perrier type C, alongside osteoblastic processes and brown tumours. A subsequent parathyroidectomy confirmed a 2 cm diameter adenoma in the right lower parathyroid lobe. Histopathology from the excised tissue confirmed the diagnosis of parathyroid adenoma.
Conclusion: Parathyroid adenomas can have significant clinical manifestations, including recurrent bone fractures, due to their metabolic effects on bone integrity. Early detection and surgical intervention can prevent complications and improve the quality of life for these patients
Factors Playing a Role in Sleep Disorders in Post-COVID-19 (Coronavirus Disease) Patients at the Neurology Polyclinic of Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Get PDFBackground: Sleep disorders are one of the symptoms frequently reported in post-COVID-19 patients. This study aims to identify factors that play a role in sleep disorders in post-COVID-19 patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
Methods: This research was conducted in an analytical observational manner with a cross-sectional design. Data was collected from 100 post-COVID-19 patients treated at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Data were analyzed using the logistic regression test.
Results: Factors that play a role in sleep disorders in post-COVID-19 patients are depressive symptoms (OR=2.5; 95%CI: 1.3-4.8); Anxiety symptoms (OR=3.1; 95%CI: 1.6-5.9); Stress level (OR=2.2; 95%CI: 1.1-4.3); Sleep quality before COVID-19 (OR=2.0; 95%CI: 1.0-3.9).
Conclusion: Symptoms of depression, anxiety, stress, and sleep quality before COVID-19 are factors that play a role in sleep disorders in post-COVID-19 patients
Colonoscopy Finding: Pseudomembranous Colitis in Chronic Kidney Disease Patient
Get PDFBackground: Gastrointestinal symptoms are common among patients with chronic kidney disease, reported in up to 70%–80% of patients with end-stage kidney disease. Several factors are involved in the pathogenesis, including the accumulation of uremic toxins and intestinal flora changes. Pseudomembranous colitis is a manifestation of severe colonic disease that is usually associated with Clostridium difficile infection but can be caused by a number of different etiologies. Pseudomembranous colitis occurs when changes in the fecal flora allow Clostridium difficile overgrowth. Gut dysbiosis, an alteration of the composition and function of gut microorganisms, is commonly seen in patients with chronic kidney disease.
Case presentation: This scientific report presents a case study of a 31-year-old woman diagnosed with pseudomembranous colitis and end-stage chronic kidney disease on hemodialysis. The colonoscopy showed yellow-white nodules that formed pseudomembranes, which were scattered between the edematous mucosa. The patient had been treated with metronidazole for 4 days, but there were side effects. The antibiotic was switched to meropenem for 6 days based on feces culture. The evaluation of colonoscopy result was normal.
Conclusion: Pseudomembranous colitis is an inflammatory bowel condition most commonly caused by Clostridium difficile infection. The presence of pseudomembranous visualization in colonoscopy can significantly establish the diagnosis
The Role of Branched-Chain Amino Acid (BCAA) Supplementation in Sarcopenia among the Elderly
Get PDFBackground: Sarcopenia is a syndrome characterized by loss of skeletal muscle mass, strength, and skeletal muscle function that occurs as a result of aging. To maintain muscle mass, a dynamic balance is needed between muscle protein synthesis (MPS) and its breakdown. BCAAs, including leucine (Leu), isoleucine (Ile), and valine (Val), have been found to have important mediating effects in protein synthesis, glucose homeostasis.
Methods: This literature review aims to explain further the role of BCAAs in sarcopenia.
Results: Numerous studies have demonstrated the advantages of BCAAs for maintaining or improving skeletal muscle mass and performance in both healthy elderly people and those with other comorbidities. It was also shown that resistance training and vitamin D supplementation enhanced the benefits of BCAAs.
Conclusion: There are still study results that contradict the role of BCAAs in sarcopenia, hence more research with homogeneity in supplementation dosage and outcome measurement methods is required in order to obtain stronger evidence to support its claims.  
Management of Isoniazid Monoresistant Tuberculosis
Get PDFlsoniazid (INH) is one of the main first-line drugs used for the treatment of active tuberculosis (TB) and latent TB infection because it has bactericidal capabilities and a good level of safety. The presence of TB germs that are resistant to INH will reduce the effectiveness of TB treatment. The treatment mix for INH monoresistant TB patients is a combination of rifampicin (R), isoniazid (H), pyrazinamide (Z), ethambutol (E), and levofloxacin (Lfx) or R-H-Z-E-Lfx given for 6 months. If a health facility provides loose TB medication, the patient can be given a combination of treatment without INH (R-Z-E-Lfx). In conditions where the Lfx drug cannot be used because there is severe intolerance (serious adverse events) or there are contra indications, the treatment given is the R-H-Z-E combination for 6 months. Clinical monitoring for patients with INH monoresistant TB follows the same principles as treatment of drug-sensitive TB. In conclusion, the treatment guide for INH monoresistant TB patients is a combination of rifampicin (R), isoniazid (H), pyrazinamide (Z), ethambutol (E), and levofloxacin (Lfx) or R-H-Z-E-Lfx for 6 months
Virological and Clinical Studies of Viral Hemorrhagic Fever (VHF): A Systematic Literature Review
Get PDFBackground: Viral hemorrhagic fever (VHF) is a group of zoonotic diseases caused by various RNA viruses, such as Ebola, Marburg, Lassa, Crimean-Congo hemorrhagic fever (CCHF), and Dengue. VHF poses a serious threat to global public health due to high morbidity and mortality rates. This study aims to conduct a systematic literature review of virological and clinical studies of VHF to understand the characteristics of the virus, pathogenesis, clinical manifestations, risk factors, diagnosis, and current therapeutic options.
Methods: A comprehensive literature search was conducted on PubMed, Scopus, and Web of Science databases to identify relevant studies published between 2018 and 2024. Studies that met the inclusion criteria were evaluated for quality and narratively synthesized.
Results: This review included 20 studies involving 2,350 VHF patients. Results demonstrated significant diversity in virologic characteristics, pathogenesis, and clinical manifestations among different types of VHF. These studies also highlight advances in molecular and serological diagnosis, as well as the development of antiviral and immunomodulatory therapies.
Conclusion: This systematic literature review provides a comprehensive summary of current knowledge regarding the virology and clinical practice of VHF. These findings may guide the development of more effective prevention, diagnosis, and treatment strategies for this life-threatening disease
The Relationship between Albumin Levels with SGOT, SGPT, and de Ritis Ratio in Chronic Hepatitis B Patients: A Single-Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Chronic hepatitis B (CHB) is a persistent hepatitis B virus (HBV) infection and can cause progressive liver damage. This damage can be measured through a decrease in albumin levels and an increase in liver enzymes such as aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT), and de Ritis ratio (AST/ALT). This study aims to analyze the relationship between albumin levels and SGOT, SGPT, and de Ritis ratio in CHB patients.
Methods: This cross-sectional retrospective analytical study involved 50 CHB patients diagnosed at Dr. M. Djamil General Hospital Padang between June 2022 to June 2023. Data on albumin levels, SGOT, SGPT, and de Ritis ratio were obtained from medical records. The de Ritis ratio, SGOT, and SGPT were grouped into normal and increased. Statistical analysis used an independent t-test with a significance of p < 0.05.
Results: The research subjects consisted of 26 men (52%) and 24 women (48%) with an average age of 42.46 ± 13.39 years. The mean albumin level in the increased SGOT group (3.69 ± 0.78 g/dL) was significantly lower than the normal SGOT group (4.39 ± 0.61 g/dL) (p = 0.003). The mean albumin level in the increased de Ritis ratio group (3.90 ± 0.80 g/dL) was also significantly lower than the normal de Ritis ratio group (4.46 ± 0.70 g/dL) (p = 0.006). There was no significant difference between albumin levels in the normal and increased SGPT groups (p = 0.548).
Conclusion: There is a significant negative relationship between albumin levels and SGOT and de Ritis ratio in CHB patients. Decreased albumin levels may be an indicator of more severe liver damage in these patients
Analysis of the Role of SARS-CoV-2 Infection on Clinical Superficial Mycosis: An Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: The COVID-19 pandemic, caused by SARS-CoV-2 infection, has had multiple impacts on human health, including its potential influence on the manifestation and severity of skin diseases such as superficial mycoses. This study aims to analyze the relationship between SARS-CoV-2 infection and the clinical characteristics of superficial mycosis in patients at Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: This analytical observational study included 150 patients with laboratory-confirmed superficial mycoses. Demographic data, medical history, SARS-CoV-2 infection status (based on RT-PCR results), and clinical characteristics of superficial mycoses were collected and analyzed using SPSS software.
Results: Of the 150 patients studied, 75 patients had a history of SARS-CoV-2 infection. No significant differences were found in the distribution of gender, age, and location of superficial mycosis infections between the groups of patients with and without SARS-CoV-2 infection. However, patients with a history of SARS-CoV-2 infection tended to have a higher severity of superficial mycosis (p < 0.05). In addition, there was a significant difference in the type of agent causing superficial mycosis between the two groups (p < 0.01).
Conclusion: SARS-CoV-2 infection may influence the clinical manifestations of superficial mycoses, especially in terms of disease severity. These findings support the importance of monitoring and management of superficial mycoses in patients with a history of SARS-CoV-2 infection
Shock Management and Hemodynamic Monitoring of Severe Dengue with Fluid Overload: A Case Report
Get PDFBackground: Dengue shock syndrome (DSS) is a life-threatening complication of dengue infection characterized by plasma leakage, shock, and organ dysfunction. Fluid management is crucial in DSS, but fluid overload can lead to adverse outcomes. This case report highlights the challenges and strategies in managing DSS with fluid overload.
Case presentation: An 8-year-old girl presented with severe dengue, DSS, encephalopathy, and fluid overload. She had a history of high fever, vomiting, and altered consciousness. Initial management focused on fluid resuscitation, but the patient developed signs of fluid overload. Hemodynamic monitoring using USCOM (Ultrasonic Cardiac Output Monitor) revealed low cardiac output and high systemic vascular resistance. Fluid restriction and inotropic support with epinephrine were initiated. The patient's condition gradually improved, and she was discharged after complete recovery.
Conclusion: This case emphasizes the importance of early recognition and careful monitoring of fluid status in DSS. Hemodynamic monitoring tools like USCOM can aid in guiding fluid management and identifying complications like fluid overload. Prompt intervention with fluid restriction and inotropic support can improve outcomes in DSS patients with fluid overload