Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Elizabethkingia meningoseptica Carbapenem Resistance in Cerebrospinal Fluid Cultures of Patients Suspected of Bacterial Meningitis: A Case Report
Get PDFBackground: Elizabethkingia meningoseptica is a Gram-negative bacterium that rarely causes meningitis in children. These infections are often resistant to carbapenem antibiotics, making diagnosis and treatment more complicated.
Case presentation: A 1-month-old male patient was treated to the PICU of Dr. M. Djamil General Hospital Padang with symptoms of decreased consciousness, seizures, and fever. The patient was diagnosed with bacterial meningitis and was referred from Sungai Dareh Regional General Hospital with previous therapy for 4 days. A cerebrospinal fluid examination showed increased protein and decreased glucose, and a CT scan showed hydrocephalus. The cerebrospinal fluid culture showed growth of Elizabethkingia meningoseptica which was resistant to imipenem and meropenem. The patient was treated with a combination of non-carbapenem antibiotics and recovered from meningitis.
Conclusion: Carbapenem-resistant Elizabethkingia meningoseptica is a rare causative agent of meningitis in children. Early diagnosis and treatment with appropriate non-carbapenem antibiotics are essential to increase the chance of cure
The Impact of Occupational Ergonomics on the Prevalence of Low Back Pain in Tailoring Professions: A Systematic Literature Review
Get PDFBackground: Low back pain (LBP) is a prevalent musculoskeletal disorder affecting individuals across various occupations, including tailoring. Tailors often engage in prolonged sitting, repetitive movements, and awkward postures, which can contribute to the development of LBP. This systematic review aims to investigate the impact of occupational ergonomics on the prevalence of LBP in tailoring professions.
Methods: A comprehensive search of electronic databases (PubMed, Scopus, Web of Science) was conducted to identify relevant studies published between 2018 and 2024. Studies that examined the relationship between ergonomic factors and LBP among tailors were included. Data extraction and quality assessment were performed independently by two reviewers.
Results: A total of 25 studies met the inclusion criteria. The findings consistently demonstrated a significant association between poor ergonomic conditions and an increased prevalence of LBP among tailors. Prolonged sitting, awkward postures, repetitive movements, and inadequate workstation design were identified as key risk factors. Additionally, the review highlighted the positive impact of ergonomic interventions, such as adjustable workstations and training programs, in reducing the prevalence and severity of LBP.
Conclusion: This systematic review provides compelling evidence that occupational ergonomics plays a crucial role in the prevalence of LBP among tailors. Implementing ergonomic interventions and promoting proper work practices can significantly reduce the burden of LBP in this population, leading to improved worker health and productivity
Argon Plasma Coagulation for Proctitis: A Meta-Analysis
Get PDFBackground: Proctitis, encompassing various etiologies, significantly diminishes patient quality of life. Argon plasma coagulation (APC) has emerged as a potential therapeutic modality, yet its efficacy and safety profile remain to be fully elucidated. This meta-analysis aimed to rigorously evaluate the effectiveness and safety of APC across diverse proctitis subtypes.
Methods: A comprehensive search of PubMed, Embase, and the Cochrane Library databases was conducted, spanning 2013 to 2023, to identify pertinent studies. Randomized controlled trials (RCTs) and observational studies comparing APC with alternative treatments or placebo in proctitis management were included. The primary outcome was clinical improvement, defined as symptom reduction or amelioration of endoscopic findings. Secondary outcomes encompassed adverse events and quality of life metrics.
Results: A total of 15 studies (5 RCTs and 10 observational studies) encompassing 2042 patients met the inclusion criteria. APC demonstrated a significant association with clinical response improvement compared to other treatments or placebo (OR 2.58, 95% CI 2.14-3.12, p<0.001). Subgroup analysis revealed APC's efficacy in both radiation-induced and non-radiation-induced proctitis. Adverse event incidence was comparable between APC and other treatments, with no significant differences in severe complications.
Conclusion: APC appears to be an effective and safe therapeutic option for various proctitis subtypes, warranting consideration in clinical practice
Preeclampsia Risk in Bali, Indonesia: The Role of Maternal Body Mass Index (BMI) and Gestational Weight Gain (GWG)
Get PDFBackground: Preeclampsia, a hypertensive disorder of pregnancy, significantly contributes to maternal and infant mortality and morbidity globally, including in Indonesia. Pre-pregnancy obesity and excessive gestational weight gain (GWG) are established risk factors for preeclampsia. This study investigated the association between pre-pregnancy body mass index (BMI) and GWG with the incidence of preeclampsia in Bali, Indonesia.
Methods: A case-control study was conducted at a Maternal Hospital in Bali, Indonesia, from May 2023 to May 2024. The study included 429 pregnant women: 143 with preeclampsia (cases) and 286 without (controls). Data were collected from medical records. BMI was categorized using Asia-Pacific criteria, and GWG was assessed based on the 2009 Institute of Medicine (IOM) guidelines. Logistic regression analysis was performed to determine the associations, adjusting for maternal age, education, and occupation.
Results: Obesity class II (BMI ≥ 30 kg/m²) and obesity class I (BMI 25.0-29.9 kg/m²) were significantly associated with an increased risk of preeclampsia, with adjusted odds ratios (AOR) of 2.90 (95% CI: 1.19-7.08) and 2.78 (95% CI: 1.60-4.81), respectively, compared to women with normal weight. Excessive GWG was also significantly associated with preeclampsia (AOR 2.53; 95% CI: 1.48-4.33) compared to adequate GWG.
Conclusion: Maternal obesity and excessive GWG are significant risk factors for preeclampsia in Bali, Indonesia. These findings underscore the importance of pre-pregnancy counseling and interventions to manage weight and promote healthy GWG to reduce the burden of preeclampsia
Propolis Extract Attenuates NF-κB Activation and Chronic Kidney Disease Progression in a Rat Model: Potential Surgical Adjuvant?
Get PDFBackground: Chronic kidney disease (CKD) is a global health concern often complicated by cardiovascular diseases like atherosclerosis. Both conditions share an inflammatory pathogenesis, with nuclear factor kappa B (NF-κB) playing a central role. Propolis, a natural bee product with anti-inflammatory properties, has shown potential in mitigating CKD progression. This study aimed to investigate the effects of propolis extract on NF-κB activation in a rat model of CKD, exploring its potential benefits as a surgical adjuvant.
Methods: Male white rats (Rattus norvegicus) were divided into three groups: a control group, a CKD group, and a CKD+Propolis group receiving propolis extract (200 mg/kg body weight) daily for 20 days. CKD was induced using the unilateral ureteral obstruction (UUO) method. NF-κB levels were measured weekly using ELISA.
Results: Propolis extract significantly reduced NF-κB levels in the CKD+Propolis group compared to the CKD group (p<0.05). This effect was consistently observed across all time points, indicating a sustained reduction in NF-κB activation with propolis treatment.
Conclusion: Propolis extract effectively attenuates NF-κB activation in a rat model of CKD, suggesting its potential as an adjunctive therapy for CKD management, particularly in the context of surgical interventions. Further research is needed to elucidate the underlying mechanisms and evaluate its efficacy in human subjects
The Role of CysC Levels as Biomarkers for Renal Function in the Use of Gentamicin for Preterm Infants Aged 28-36 Weeks with Neonatal Sepsis: A Narrative Literature Review
Get PDFPremature infants with neonatal sepsis often require antibiotics, such as Gentamicin, commonly used in the NICU to treat suspected Gram-negative infections associated with neonatal sepsis. However, to limit the risk of nephrotoxicity associated with minimum levels, the use of high-dose Gentamicin with extended dosing intervals has been widely adopted in NICU clinical practice. Gentamicin use can impact kidney function. The examination of Cystatin C (CysC) levels as a biomarker to assess kidney function and nephrotoxicity due to antibiotic use is highly recommended, especially in premature infants. Gentamicin use in preterm infants can influence CysC levels as a biomarker for kidney function. The correlation between Gentamicin use, changes in CysC levels, and the impact on kidney function highlights the need for strict monitoring of these parameters. This study concludes that CysC levels can be a crucial indicator in assessing the impact of Gentamicin use on kidney function in preterm infants with neonatal sepsis. Routine monitoring of CysC levels can aid in early identification of potential kidney issues and support appropriate clinical decision-making in the use of antibiotics for this vulnerable preterm infant population
Predicting Mortality in Pulmonary Alveolar Proteinosis: A Meta-Analysis of Prognostic Factors
Get PDFBackground: Pulmonary alveolar proteinosis (PAP) is a rare lung disease with a variable clinical course. This meta-analysis aimed to synthesize the available evidence on prognostic factors associated with mortality in patients with PAP.
Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases for studies published from 2013 to 2024. Studies reporting prognostic factors associated with mortality in patients with PAP were included. Data on study characteristics, patient demographics, clinical variables, and outcomes were extracted. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for dichotomous outcomes, and hazard ratios (HRs) and 95% CIs were calculated for time-to-event outcomes. Random-effects meta-analysis was used to pool data, and heterogeneity was assessed using the I² statistic.
Results: Six studies with a total of 1,375 PAP patients were included in the meta-analysis. The pooled analysis showed that several factors were significantly associated with increased mortality in PAP. These included older age (HR 1.45, 95% CI 1.02-1.9, p < 0.001), lower diffusing capacity for carbon monoxide (DLCO) % predicted (HR 0.87, 95% CI 0.65-0.98, p < 0.001), higher serum lactate dehydrogenase (LDH) levels (OR 2.50, 95% CI 1.80-3.47, p < 0.001), lower arterial oxygen tension (PaO2) (HR 0.89, 95% CI 0.78-0.98, p=0.002), and a diagnosis of secondary PAP (OR 3.85; 95% CI 2.19-5.56, p <0.001). Heterogeneity was moderate to high for most analyses.
Conclusion: This meta-analysis identified several clinical and laboratory parameters associated with increased mortality in PAP. These factors could be used to identify high-risk patients who may benefit from closer monitoring and more aggressive treatment strategies. Further prospective studies are needed to validate these findings and to develop accurate predictive models for mortality in PAP
Complex Case: Acute-on-Chronic Gouty Arthritis, Septic Arthritis, and Severe Joint Deformities in a Young Adult Patient
Get PDFBackground: Gout is the most prevalent type of inflammatory arthritis, which can lead to inflammation in the joints. However, septic arthritis is unusual in gout.
Case presentation: A 34-year-old male presented with lumps on the right ankle with cloudy white fluid discharge for 5 days prior to admission. The patient also has lumps observed on the left pedis, and manus bilateral. The patient regularly takes Allopurinol daily and Piroxicam prior to admission. The physical examination had a limited range of movement. Laboratory examinations found elevated uric acid, impaired renal function, elevated white blood cells, and elevated erythrocyte sedimentation rate. The patient was then referred for surgical debridement.
Conclusion: Chronic gout marked by persistent polyarticular engagement and the formation of tophi. In individuals left untreated, septic arthritis and gout may manifest, followed by deformities of joints, which need further diagnosis and management
Comparison of Immature Platelet Fraction (IPF) Values for ACS Patients with Unstable Angina Pectoris (UAP), Non-ST Elevation Myocardial Infarct (NSTEMI), and ST Elevation Myocardial Infarct (STEMI)
Get PDFBackground: Acute coronary syndrome (ACS) is a medical emergency that requires rapid diagnosis and treatment. Immature platelet fraction (IPF) is a hematological parameter that has the potential to be a biomarker for differentiating types of ACS. This study aims to compare IPF values in ACS patients with unstable angina pectoris (UAP), Non-ST elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI).
Methods: This research is an analytical observational study with a cross-sectional design. The research subjects were ACS patients treated at Dr. M. Djamil General Hospital, Padang, Indonesia between January 2023 to December 2023. IPF values were measured using the Sysmex XN-1500 tool. Statistical analysis was carried out using the ANOVA test and post-hoc Tukey test.
Results: A total of 150 ACS patients (50 UAP, 50 NSTEMI, 50 STEMI) were included in this study. The mean IPF value in the STEMI group (6.8 ± 2.1%) was significantly higher than that in the NSTEMI (4.5 ± 1.8%) and UAP (3.2 ± 1.5%) groups (p < 0.001). ROC analysis showed that the IPF value had an AUC of 0.89 (95% CI: 0.84-0.94) for differentiating STEMI from NSTEMI/UAP.
Conclusion: IPF values were higher in STEMI patients compared to NSTEMI and UAP. This parameter has the potential to be a biomarker for differentiating types of ACS, especially in differentiating STEMI from NSTEMI/UAP
Polycystic Kidney Disease with Breast Nodules in a Male: A Case Report
Get PDFBackground: Polycystic kidney disease is a multisystem and progressive congenital kidney disorder characterized by kidney enlargement and the growth of cysts in the kidneys and other organs. Autosomal dominant polycystic kidney disease (ADPKD) is the most common type of inherited kidney disorder and is observed in 1/500 – 1/1000 people. The diagnosis is usually made by a positive family history , and the Ravine ultrasonographic criteria assess the age and number of cysts in both kidneys.
Case presentation: A 37-year-old male was reported with complaints of intermittent hematuria and a painless lump in the right breast for the last 6 years. Patients routinely drink herbal medicine when symptoms appear. Abdominal physical examination revealed renal ballottement. The lump in the right breast is palpable as a lump ± 1 cm from the nipple. No abnormalities in kidney or liver function were found on laboratory examination. Ultrasound was performed, and polycystic kidney disease was obtained in both kidneys and liver, as well as a hypervascular solid nodule in the right breast. The patient was given antibiotics and antifibrinolytics. Healthy lifestyle education is also provided to patients. The patient was then referred for a biopsy of the nodule.
Conclusion: Autosomal dominant polycystic kidney disease (ADPKD) is a common disease but only a few cases of ADPKD are accompanied by nodules in the breast, so a further approach is needed