Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Relationship between Serum p-Tau Levels and Impaired Cognitive Function in Type 2 Diabetes Mellitus
Get PDFBackground: Type 2 diabetes mellitus (Type 2 DM) is a metabolic disease that causes a global crisis that threatens health and the world economy. Impaired cognitive function is a key factor in reducing health-related quality of life in type 2 DM patients. Phosphorylated Tau (p-Tau) is a microtubule protein that functions in cell signaling, synaptic plasticity, and regulation of genome stability. A malfunction of p-Tau will cause disruption of cell signaling, which can result in impaired cognitive function. This study aims to assess the relationship between serum p-Tau levels and impaired cognitive function in type 2 diabetes mellitus patients.
Methods: This research is an observational study, comparative analysis with a cross-sectional design with a sample of 60 type 2 diabetes mellitus patients who sought treatment at the endocrine polyclinic at Dr. M. Djamil General Hospital Padang. Cognitive function was assessed using MoCa-Ina. Serum p-Tau levels were measured using the ELISA method. Data analysis was carried out using SPSS.
Results: The average serum p-Tau level in type 2 diabetes mellitus patients with impaired cognitive function was 542.9 pg/ml. The cut-off point for serum p-Tau levels which is associated with impaired cognitive function in type 2 diabetes mellitus patients is 517.2 pg/ml. There was a significant relationship between serum p-Tau levels and impaired cognitive function in type 2 diabetes mellitus patients (p=0.039).
Conclusion: There is a significant relationship between serum p-Tau levels and impaired cognitive function in type 2 diabetes mellitus patients
Changes in Retinal Ganglion Cell (RGC) and Retinal Nerve Fiber Layer (RNFL) Thickness in Children with Type 1 Diabetes Mellitus at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Type 1 diabetes mellitus (DM) is a chronic metabolic disorder that causes hyperglycemia and increases the risk of morbidity and mortality. Diabetic retinopathy, a microvascular complication that often occurs in DM patients, can cause visual impairment and even blindness. Regular eye examinations are important for early detection of diabetic retinopathy. Optical coherence tomography (OCT) is a non-invasive method that can be used to measure the thickness of retinal layers, including RGC and RNFL. It is thought that thinning of the retinal layer can be a sensitive biomarker in detecting diabetic retinopathy in type 1 DM patients. This study aims to determine changes in RGC and RNFL thickness in children with type 1 DM.
Methods: This cross-sectional design analytical observational study was conducted at the eye polyclinic of Dr. M. Djamil General Hospital Padang in November 2023-March 2024. A total of 46 eyes from 46 people, divided into two groups: the type 1 DM group and the control group, were recruited in this study. RGC thickness was measured using AS-OCT GC-IPL thickness analysis and RNFL with optic disc RNFL thickness analysis. Data analysis was carried out using the unpaired T-test.
Results: The results showed RGC depletion in the type 1 DM group (RGC 83.48 ± 3.75) compared to the control group (RGC 86.70 ± 4.87) with a value of p = 0.016 (p < 0.05). There was no statistical difference in RNFL thickness between the type 1 DM group (RNFL 102 ± 11.80) and the control group (RNFL 100.96 ± 10.97) with a value of p = 0.581 (p> 0.05).
Conclusion: This study found RGC thinning in type 1 DM patients, but did not find differences in RNFL thickness between the two groups. This RGC depletion is thought to be caused by apoptosis of retinal neuronal cells due to chronic hyperglycemia. Examination of RGC thickness with OCT can be developed as an early detection of diabetic retinopathy in children with type 1 DM
Differences in D-Dimer Levels in Acute Ischemic and Hemorrhagic Stroke: Observational Study in the Emergency Department of Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Stroke is the second largest cause of death worldwide with a high morbidity rate of up to 50% of survivors get chronic disability. Rapid diagnosis in patients with suspected acute ischemic or hemorrhagic stroke is very important to determine management and prognosis. D-dimer is an indirect marker of fibrinolysis which functions as a significant marker of activation of coagulation and fibrinolysis. This study aims to determine the differences in D-dimer levels in ischemic and acute hemorrhagic stroke patients in the emergency room (ER) of Dr. M. Djamil General Hospital Padang.
Methods: Analytical observational research by cross-sectional design was carried out on 56 samples consisting of 28 acute ischemic and 28 acute hemorrhagic stroke samples for the period December 2022-June 2023. D-dimer levels and CTscan checked on each group and analysis is carried out.
Results: The most common characteristics of research subjects were men, namely 35 patients (62.5%) and aged 51-60 years (32.1%). The mean D-dimer levels for ischemic and hemorrhagic strokes were 794.33 ng/mL (±2.63) and 1288.25 ng/mL (±2.51) with a p-value = 0.055.
Conclusion: The mean D-dimer in acute hemorrhagic stroke was higher than in acute ischemic stroke but there was no statistically significant difference. The D-dimer examination cannot differentiate the type of stroke that occurred
Overview Profile of High Sensitive Troponin I (hsTnI) Levels Based on Infarction Location in Acute Myocardial Infarction Patients: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Acute myocardial infarction (AMI) remains an important health problem globally. A diagnosis of AMI can be made by finding at least two of the three criteria, namely typical angina pain, electrocardiography (ECG) abnormalities, and increased cardiac biomarkers. Variations in troponin levels based on examination time and infarct location were obtained from previous studies. High-sensitive troponin I (hsTnI) is a very specific biomarker in detecting myocardial damage. This study aims to determine the description of hsTnI levels based on the location of the infarction in AMI patients of Dr. M. Djamil General Hospital Padang. The location of the infarction in AMI determines the management and prognosis for the clinician.
Methods: This research is a retrospective study with a cross-sectional design at the Laboratory Installation of Dr. M. Djamil General Hospital Padang. The sample was adult patients diagnosed with AMI with complete data that met the inclusion and exclusion criteria, taken from medical records.
Results: This study showed that from a total of 140 AMI patients, 67 samples met the inclusion criteria. A total of 67 AMI patients consisted of 59 men (88.06%) and 8 women (11.94%) with an average age of 60.1 + 10.5 years. The highest hsTnI levels were found at the posterior infarction location, 40,000 ng/L (16,639-48,997). The location of the infarction was dominated by the inferior infarction location in 20 people (29.9%).
Conclusion: The highest hsTnI levels were found at the posterior infarction location. The location of the infarction is dominated by the inferior infarction location in AMI patients with ST elevation at Dr. M. Djamil General Hospital Padang
Overview of Central Corneal Thickness in Patients with Glaucoma: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Central corneal thickness (CCT) is an important risk factor in the diagnosis and management of glaucoma. This study aims to determine the CCT picture of various types of glaucoma at Dr. M. Djamil General Hospital Padang.
Methods: This descriptive retrospective study involved data from glaucoma patients at Dr. M. Djamil General Hospital Padang for the period January 2019 - December 2020. CCT data was obtained from medical records and OCT computer data. Descriptive analysis was carried out to see the distribution of CCT in ocular hypertension (OHT), glaucoma suspect (GS), normal tension glaucoma (NTG), primary open-angle glaucoma (POAG), and juvenile open-angle glaucoma (JOAG) groups.
Results: A total of 123 glaucoma patients were analyzed. The overall mean CCT was 535.50 ± 43.82 µm. The highest mean CCT was in the OHT group (566.30 ± 32.07 µm) and the lowest in POAG (523.39 ± 39.43 µm). The mean age of patients was 35.19 ± 16.20 years. The POAG group had the highest mean age (52.52 ± 9.54 years), while the JOAG group had the lowest (22.00 ± 5.84 years).
Conclusion: There are variations in CCT in various types of glaucoma, with OHT having the highest CCT and POAG the lowest. This data can be a basis for consideration in the diagnosis and management of glaucoma in Indonesia
Differences in Cerebrospinal Fluid Glucose Levels in Meningitis Patients Based on Examination Time: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Cerebrospinal fluid (CSF) is a vital fluid in the central nervous system that can provide important diagnostic information, especially in cases of meningitis. CSF glucose is one of the key parameters that can help in the diagnosis and monitoring of the patient's condition. However, the stability of glucose in the CSF after sampling is of concern due to the potential for levels to decrease over time.
Methods: This cross-sectional analytical observational study was conducted at Dr. M. Djamil General Hospital Padang between May and August 2023. CSF samples from patients with suspected meningitis were checked for glucose levels at three time points: the first 1 hour, 2 hours, and 4 hours after sample collection. Patients with puncture trauma and late delivery of samples (more than 30 minutes) were excluded.
Results: This study involved [number of patients] CSF samples that met the inclusion criteria. The mean decrease in CSF glucose levels between the 1-hour and 2-hour examination was 5.667 mg/dL (±0.75 mg/dL), while between 1 hour and 4 hours, it was 12.183 mg/dL (±1.549 mg/dL). Statistical analysis showed significant differences (p < 0.001) between the three examination time points.
Conclusion: Glucose levels in the CSF of meningitis patients decreased significantly over time after sampling. This emphasizes the importance of checking CSF glucose as soon as possible to obtain accurate results and avoid misinterpretation in the diagnosis and treatment of meningitis
Analysis of Bioterrorism Studies on Lung Health: A Meta-Analysis
Get PDFBackground: Bioterrorism, the use of biological agents to cause mass harm, poses a significant threat to lung health. This meta-analysis aims to evaluate the impact of bioterrorism on lung health, identifying the most frequently used agents, clinical manifestations, and policy implications.
Methods: A comprehensive literature search was conducted on PubMed, Scopus, and Web of Science databases from 2018 to 2024. Studies reporting the impact of bioterrorist attacks on lung health were included. Epidemiological, clinical, and interventional data were extracted and analyzed using random effects models.
Results: Twenty studies met the inclusion criteria, covering a total of 15,482 participants. The most common bioterrorism agent was Bacillus anthracis (43.5%), followed by Yersinia pestis (21.7%) and Francisella tularensis (17.4%). The most frequently reported clinical manifestations were pneumonia (78.3%), acute respiratory failure (39.1%), and sepsis (26.1%). Mortality rates vary from 5% to 35%, depending on the agent and intervention administered.
Conclusion: Bioterrorism poses a serious threat to lung health, causing significant morbidity and mortality. Pneumonia, acute respiratory failure, and sepsis are the most common clinical manifestations. It is important to improve preparedness, early detection, and clinical management to reduce the impact of bioterrorist attacks
Analysis of Risk Factors for Cognitive Frailty: A Meta-Analysis
Get PDFBackground: Cognitive frailty (CF) is a syndrome characterized by cognitive and physical decline in older adults, which increases the risk of disability, dependency, and mortality. This study aims to identify and analyze risk factors for CF incidence through a systematic review and meta-analysis.
Methods: A literature search was conducted on PubMed, Scopus, and Web of Science databases until June 2024. Observational studies reporting associations between potential risk factors and CF incidence in the elderly population were included. Two independent researchers performed study selection, data extraction, and risk of bias assessment. Meta-analysis was performed using a random effects model, and heterogeneity between studies was evaluated.
Results: A total of 25 studies (n=45,678 participants) met inclusion criteria. Meta-analysis showed that advanced age (OR=1.89; 95% CI 1.65-2.16), female gender (OR=1.38; 95% CI 1.19-1.60), history of cardiovascular disease (OR=1.52; 95% CI 1.23-1.87), diabetes mellitus (OR=1.45; 95% CI 1.18-1.78), depression (OR=2.08; 95% CI 1.72-2.51), and low physical activity (OR=1.63; 95% CI 1.35-1.97) are risk factors significant for the incidence of CF. Low educational level (OR=1.71; 95% CI 1.43-2.04), low socioeconomic status (OR=1.58; 95% CI 1.29-1.93), and smoking history (OR=1.31; 95% CI 1.05-1.64) were also associated. with an increased risk of CF.
Conclusion: This study identified several modifiable and nonmodifiable risk factors for CF occurrence. Interventions targeting these risk factors may help prevent or delay the development of CF in older adults
Prevalence and Analysis of Risk Factors for RAI-Refractory Thyroid Cancer Patients: A 5-Year Retrospective Analysis from a Single Institution in Indonesia
Get PDFBackground: Radioactive iodine (RAI) therapy is a cornerstone in the management of differentiated thyroid cancer (DTC). However, a subset of patients develops RAI-refractory disease, characterized by the inability to concentrate radioiodine, leading to limited treatment options and a poorer prognosis. This study aimed to investigate the prevalence and identify potential risk factors associated with RAI-refractory DTC in an Indonesian population.
Methods: A retrospective analysis was conducted on patients diagnosed with DTC and treated with RAI at a single tertiary care center in Indonesia between 2019 and 2023. Data on demographics, clinical characteristics, tumor features, and treatment outcomes were collected. RAI-refractoriness was defined as the absence of iodine uptake on diagnostic whole-body scans after cumulative RAI activity of 600 mCi or more. Bivariate and multivariate analyses were performed to identify risk factors for RAI-refractoriness.
Results: A total of 194 patients with DTC were included in the study. The prevalence of RAI-refractoriness was 90%. The median age at diagnosis was 55 years (range 18-82), and 72% were female. Papillary thyroid carcinoma was the most common histological subtype (92%). In bivariate analysis, older age at diagnosis (p=0.02), male gender (p=0.04), and the presence of distant metastases at diagnosis (p<0.001) were significantly associated with RAI-refractoriness. In multivariate analysis, only the presence of distant metastases remained an independent predictor of RAI-refractoriness (odds ratio 3.8, 95% confidence interval 1.5-9.2, p=0.003).
Conclusion: RAI-refractoriness is a significant clinical challenge in the management of DTC, with a high prevalence observed in this Indonesian cohort. The presence of distant metastases at diagnosis emerged as a strong predictor of RAI-refractoriness. Further research is needed to elucidate the underlying mechanisms of RAI-refractoriness and develop novel therapeutic strategies for this patient population
Predicting Conversion to Open Cholecystectomy: A Validation Study of the Difficult Laparoscopic Cholecystectomy Scoring System
Get PDFBackground: Laparoscopic cholecystectomy (LC) has become the gold standard for managing symptomatic gallstone disease. However, a subset of patients requires conversion to open cholecystectomy (OC) due to intraoperative difficulties. The difficult laparoscopic cholecystectomy scoring system (DLCSS) has been proposed to predict the likelihood of conversion. This study aimed to validate the DLCSS in a single-center setting and assess its predictive accuracy for conversion to OC.
Methods: A retrospective analysis was conducted on patients who underwent LC at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia, between January and December 2023. Preoperative, intraoperative, and postoperative data were collected. The DLCSS was calculated for each patient, and its correlation with conversion to OC was analyzed using statistical methods.
Results: A total of 30 patients were included in the study. The conversion rate to OC was 3.3%. Statistical analysis revealed a weak negative correlation between the DLCSS and conversion to OC (r = -0.318, p = 0.087), suggesting that higher DLCSS scores were associated with a slightly increased likelihood of conversion, although this association was not statistically significant.
Conclusion: The DLCSS demonstrated limited predictive value for conversion to OC in our single-center study. Further research with larger sample sizes and diverse patient populations is needed to confirm the utility of the DLCSS in predicting conversion and to identify additional factors that may contribute to intraoperative difficulties during LC