Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Delayed-Onset Surgical Site Infection after Sphenoid Wing Meningioma Resection: A Case Report Highlighting Diagnostic and Management Challenges
Get PDFBackground: Surgical site infections (SSIs) following craniotomy, while uncommon, pose significant risks. Delayed-onset infections can present diagnostic and management challenges. We report a case of delayed-onset SSI after sphenoid wing meningioma resection, emphasizing the importance of vigilance and prompt intervention.
Case presentation: A 26-year-old male underwent craniotomy for a right sphenoid wing meningioma. He presented 13 days post-operatively with a fluctuant swelling at the surgical site. Imaging revealed a subgaleal and epidural abscess. He underwent craniectomy, debridement, and antibiotic therapy, resulting in complete resolution.
Conclusion: Delayed-onset SSIs after craniotomy necessitate a high index of suspicion. Early diagnosis and aggressive management, including surgical debridement and appropriate antibiotics, are crucial for optimal outcomes
Leukopenia as a Prognostic Factor in Severe Community-Acquired Pneumonia with Sepsis: A Case Report
Get PDFBackground: Community-acquired pneumonia (CAP) is a major cause of sepsis, and severe CAP with sepsis is associated with significant morbidity and mortality. Leukopenia, a decrease in white blood cell count, has been identified as a potential prognostic factor in sepsis, suggesting a poorer outcome. This case report aims to evaluate the role of leukopenia in predicting the clinical course and outcome of a patient with severe CAP and sepsis.
Case presentation: A 73-year-old male presented with complaints of shortness of breath, cough, fever, and altered mental status. He was diagnosed with severe CAP with sepsis and sepsis-associated encephalopathy (SAE). Laboratory investigations revealed leukopenia. The patient's clinical condition improved over 10 days of treatment, coinciding with an improvement in his white blood cell count.
Conclusion: This case report highlights the potential prognostic value of leukopenia in patients with severe CAP and sepsis. The patient's clinical improvement paralleled the recovery of his white blood cell count, suggesting that leukopenia may serve as a marker of disease severity and treatment response. Further studies are needed to validate these findings and establish the role of leukopenia in the management of severe CAP with sepsis
A Suspicious Cup Disc with High Intraocular Pressure (IOP) and Normal Perimetry: A Rare Self Case Report
Get PDFBackground: Intraocular pressure (IOP) assessment involves evaluating the force exerted by aqueous humor on the internal surface of the anterior eye. Elevated IOP poses a substantial risk for glaucomatous optic neuropathy and is a key modifiable clinical risk factor. This study aims to explore cases of ocular hypertension coupled with optic nerve cupping, suspected to be glaucoma, providing comprehensive details of examination results, diagnosis, and subsequent management.
Case presentation: A 23-year-old Asian male underwent an ocular examination, revealing average IOP levels measured using non-contact tonometry. Despite no complaints, consecutive measurements noted 28 mmHg for the right eye and 26 mmHg for the left eye. Initial assessments by a glaucoma specialist indicated open-angle anterior chambers. Optical coherence tomography revealed cup disc ratios of 0.7 to 0.8 for both eyes. Medication (Timol) was prescribed, adjusting with oral citicoline and brinzolamide. The diagnosis evolved to juvenile open-angle glaucoma (JOAG). Visual field testing showed normal results. Discontinuation of treatment led to reclassifying the diagnosis as ocular hypertension and scheduling follow-up OCT examinations for five years.
Conclusion: The patient exhibited corneal thickness ≥610 μm, CDR ≥0.7 μm, IOP >25 mmHg, and maintained good visual field conditions. Additional research is essential to understand the correlation between corneal thickness and other eye conditions. Recognizing potential overdiagnosis due to high IOP and large CDR emphasizes the need for meticulous clinical assessment and advanced diagnostic examinations to distinguish physiological and pathological conditions
Local Anesthetics with Vasoconstrictors in Hypertensive Patients Undergoing Dental Extraction Procedures: A Serial Case Report
Get PDFBackground: Systemic absorption of vasoconstrictors and adverse cardiac effects are reasons for not using vasoconstrictors in hypertensive patients. However, several recent studies reported that the use of local anesthetics with vasoconstrictors in hypertensive patients doesn’t cause a statistically significant increase in blood pressure and heart rate. The objective of the study is to evaluate the preoperative, intraoperative and postoperative blood pressure, heart rate and peripheral oxygen saturation in hypertensive patient who undergoing dental extraction procedures with local anesthetics with vasoconstrictors.
Case presentation: We reported three serial cases of male patients (40, 45, 47 years old) undergoing radixes lower posterior tooth extracted, with blood pressures 143/88mmHg, 140/86mmHg and 142/86 mmHg. The patient underwent extraction under infiltration local anesthetics with vasoconstrictors (epinephrine). All patient’s blood pressure increased 1-3 points intraoperative and decreased again postoperative. The patient's heart rate also increased 10-25 times per minute intraoperative. The decrease in oxygen saturation (2%) only occurred in one patient, intraoperative.
Conclusion: The slight hemodynamic changes in these three patients indicate that the use of local anesthetics with vasoconstrictors in hypertensive patients undergoing dental extraction procedures is relatively safe
Supraclavicular Block Using Ultrasonography (USG) Guidance in Ulna Radius Fractures Patients with Moderate Mitral Regurgitation Undergoing ORIF (Open Reduction and Internal Fixation): A Case Report
Get PDFBackground: Open fractures of the radius and ulna in elderly patients are conditions that require fast and appropriate treatment. Open reduction internal fixation (ORIF) is a common treatment option, but in elderly patients, general anesthesia may be high risk. Supraclavicular brachial plexus block is an effective and safe regional anesthetic option for ORIF in elderly patients.
Case presentation: We report the case of a 71-year-old man with an open fracture of the left third radius and middle ulna who was planned for ORIF. The patient had comorbid hypertension and reduced left ventricular function. Supraclavicular brachial plexus block was performed using 0.5% bupivacaine (10 mL) and 2% lidocaine (10 mL). The patient did not complain of pain during the operation and recovered well.
Conclusion: Supraclavicular brachial plexus block is an effective and safe regional anesthetic option for ORIF in elderly patients with open fractures of the radius and ulna
Characteristics, Clinical, and Trichoscopic Features in Pediatric Patients with Alopecia Areata: A Single-Center Observational Study at the Dermatology Clinic of Dr. M. Djamil General Hospital Padang
Get PDFBackground: Alopecia areata (AA) is an autoimmune disease that causes patchy hair loss. In children, AA can have a significant psychological impact. This study aims to identify the characteristics, clinical and trichoscopic features of AA pediatric patients at the dermatology clinic of Dr. M. Djamil General Hospital Padang.
Methods: This cross-sectional analytical observational study involved pediatric patients (<18 years) with a diagnosis of AA who came to the dermatology clinic of Dr. M. Djamil General Hospital Padang between January 2020 to December 2023. Demographic data, disease history, clinical features, and trichoscopy examination results were collected and analyzed descriptively.
Results: A total of 125 pediatric AA patients met the inclusion criteria. The majority of patients were female (62.4%) with a mean age of 10.5 years. The most common form of AA is patchy (80%), followed by alopecia totalis/universalis (12%) and ophiasis (8%). A history of atopy was found in 35.2% of patients. The most frequently found trichoscopic features were yellow dots (78.4%), black dots (64%), and broken hairs (56%).
Conclusion: This study provides a comprehensive description of the characteristics, clinical and trichoscopic characteristics of AA pediatric patients at Dr. M. Djamil General Hospital Padang. These findings may provide a basis for the development of better management strategies for AA in children
The Role of NT-proBNP in the Diagnosis of Peripartum Cardiomyopathy with Multiple Left Ventricular Thrombus: A Case Report
Get PDFBackground: Peripartum cardiomyopathy (PPCM) is a rare but serious condition characterized by left ventricular dysfunction in late pregnancy or early postpartum. Early diagnosis is essential to prevent complications such as thromboembolism. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a promising biomarker for the diagnosis of PPCM.
Case presentation: An 18-year-old female presented with progressive shortness of breath and generalized edema. Physical examination and echocardiography revealed acute heart failure with multiple left ventricular thrombus. Very high levels of NT-proBNP (1,796 pg/mL) supported the diagnosis of PPCM. The patient was successfully treated with standard heart failure therapy and anticoagulants.
Conclusion: This case report highlights the importance of NT-proBNP in the early diagnosis of PPCM and detecting of thromboembolic complications. Significant increases in NT-proBNP levels, even without obvious symptoms, should be promptly evaluated for PPCM, especially in high-risk populations
Successful Management of Complex Intestinal Tuberculosis with Ileal Perforation: A Case Report
Get PDFBackground: Intestinal tuberculosis (ITB) with ileal perforation represents a formidable challenge in the realm of extrapulmonary tuberculosis. This case report underscores the complexities inherent in managing such cases, highlighting the critical need for a multidisciplinary approach that integrates pharmacological and surgical interventions.
Case presentation: A 57-year-old male presented with a history of both pulmonary and intestinal tuberculosis, complicated by ileal perforation. He had previously undergone a six-month course of anti-tuberculosis treatment and a laparotomy for ileal perforation repair. The patient's current presentation included abdominal pain, nausea, and vomiting, indicative of obstructive ileus. Diagnostic assessments revealed elevated inflammatory markers and imaging confirmed partial obstructive ileus and active pulmonary tuberculosis. The patient was managed with extended anti-tuberculosis therapy and intravenous antibiotics, resulting in significant clinical improvement and enhanced quality of life.
Conclusion: This case report emphasizes the importance of early detection, comprehensive assessment, and individualized treatment plans in managing complex ITB cases. The successful outcome achieved in this case underscores the efficacy of a multidisciplinary approach that combines pharmacological and surgical interventions
Ethnic Differences in Myopia: Axial Length and Central Corneal Thickness in the Minang Population
Get PDFBackground: Myopia is a prevalent vision disorder characterized by blurred distance vision. It is often associated with increased axial length (AL) and alterations in central corneal thickness (CCT). This study investigated the relationship between AL and CCT in individuals from the Minang ethnic group in Indonesia with varying degrees of myopia.
Methods: A cross-sectional study was conducted at the Ophthalmology Clinic of Dr. M. Djamil General Hospital Padang from June to July 2024. The study involved 33 eyes from Minangkabau patients with myopia, categorized into three groups: mild, moderate, and high myopia. Axial length was measured using A-scan Biometry (immersion technique), and central corneal thickness (CCT) was assessed using Anterior Segment Optical Coherence Tomography (AS-OCT).
Results: Significant differences were observed in the average values of AL and CCT among mild myopia (AL 23.93 ± 0.650 mm, CCT 530.45 ± 38.534 µm), moderate myopia (AL 25.03 ± 0.516 mm, CCT 518.64 ± 26.223 µm), and high myopia (AL 27.12 ± 1.524 mm, CCT 509.45 ± 30.422 µm) groups, with a p-value of 0.037 (p<0.05) and r = -0.729. A strong correlation between AL and CCT was found in individuals with myopia among the Minangkabau ethnic group (r = -0.729, p = 0.037).
Conclusion: Higher degrees of myopia are associated with increased axial length and reduced central corneal thickness in the Minang ethnic group. These findings highlight the importance of considering ethnic differences in the assessment and management of myopia
Cystic Fibrosis Lung Disease: A Narrative Literature Review
Get PDFCystic fibrosis (CF) is caused by mutations in autosomal recessive genes that code for proteins cystic fibrosis transmembrane conductance regulator (CFTR) which is located on chromosome seven. The CFTR protein under normal conditions acts as a chloride channel and helps the movement of sufficient electrolytes and water across the membrane. Mutations in CFTR cause abnormalities in chloride ion transport through epithelial cells and impaired sodium and water transport resulting in viscous secretions with low water content. This thick and sticky secretion will inhibit the normal function of various organs, although pulmonary complications are the most common cause of death. Cystic fibrosis has wide genotypic and phenotypic variations. There are six categories of mutations based on their effect on the CFTR protein, where these categories are not only used to predict the phenotype but also to determine better therapeutic strategies based on the identified mutations