Bioscientia Medicina - Journal of Biomedicine and Translational Research
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    1245 research outputs found

    Quantifying the Pulmonary Risks of Volcanic Gas Inhalation: A Meta-Analysis

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    Background: Volcanic eruptions release a complex mixture of gases and particulate matter, posing significant respiratory health risks. This meta-analysis aims to quantify the association between volcanic gas inhalation and adverse pulmonary effects. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for studies published between 2013 and 2024 investigating the respiratory effects of volcanic gas exposure. Studies reporting quantitative data on lung function, respiratory symptoms, or disease prevalence were included. Random-effect models were used to pool effect estimates, and heterogeneity was assessed using the I² statistic. Results: Six studies (n = 2,215 participants) met the inclusion criteria. Volcanic gas exposure was associated with a significant decrease in FEV1 (forced expiratory volume in 1 second) (standardized mean difference [SMD] = -0.55, 95% CI: -0.67 to -0.42, I² = 51%), increased prevalence of asthma (odds ratio [OR] = 3.31, 95% CI: 1.84 to 5.96, I² = 76%), and chronic bronchitis (OR = 2.86, 95% CI: 1.97 to 4.15, I² =0%). Subgroup analysis revealed a stronger association between gas exposure and respiratory effects in children and individuals with pre-existing lung conditions. Conclusion: This meta-analysis provides compelling evidence that volcanic gas inhalation is detrimental to respiratory health. Public health interventions should prioritize vulnerable populations during and after volcanic eruptions

    An Unusual Case of Pemphigus Foliaceus Arising in a Patient with Psoriasis Vulgaris

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    Background: Pemphigus foliaceus (PF) is a rare autoimmune blistering disease characterized by superficial, fragile blisters. Psoriasis vulgaris, a chronic inflammatory skin condition, has been rarely associated with PF. This case report presents an unusual instance of PF developing in a patient with a history of psoriasis vulgaris. Case presentation: A 54-year-old Indonesian woman presented with a one-year history of scaly skin and reddish spots across her body, worsening over the past week. She had a prior diagnosis of psoriasis vulgaris and was undergoing methotrexate therapy (15 mg/week) without significant improvement. Three months prior, she developed loose blisters on her back that spread to her hands, rupturing easily and leaving painful sores. The patient denied any mucosal involvement. One week before her presentation, her symptoms worsened following relocation-related stress. Dermatological examination revealed generalized multiple erythematous patches with scales, some with ruptured blisters leaving erosions, and a positive Nikolsky sign. Histopathological examination confirmed PF. The patient was treated with intravenous methylprednisolone, oral erythromycin and paracetamol, topical mupirocin, and clobetasol. After one month, due to a lack of improvement, azathioprine was added, leading to lesion improvement without side effects. Conclusion: This case highlights the rare but potential development of PF in patients with psoriasis vulgaris. The complex interplay between these two conditions warrants further investigation. Early diagnosis and appropriate treatment are crucial for managing PF and improving patient outcomes

    Rare and Fatal Complication: A Case of Ketorolac-Induced Anaphylaxis Leading to Cardiac Arrest and Hypoxic-Ischemic Brain Injury in a Young Adult

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    Background: Anaphylaxis is a severe, life-threatening allergic reaction that can lead to cardiac arrest and hypoxic-ischemic brain injury (HIBI). Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID) commonly used for postoperative pain management, has been rarely associated with anaphylaxis. Case presentation: We present the case of a 32-year-old woman who developed anaphylaxis and subsequent cardiac arrest following intravenous administration of ketorolac after an appendectomy. Despite successful resuscitation, the patient suffered from HIBI and remained in a persistent vegetative state. Conclusion: This report highlights the potential for fatal complications associated with ketorolac administration and emphasizes the importance of prompt recognition and management of anaphylaxis in the perioperative setting. This case underscores the need for heightened vigilance regarding potential anaphylactic reactions to ketorolac, even in patients with no prior history of drug allergies. Early recognition and aggressive management of anaphylaxis are crucial to minimize the risk of severe complications like cardiac arrest and HIBI

    A Case of Infectious Keratitis Associated with Rigid Gas Permeable Contact Lens Use in a Keratoconus Patient

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    Background: Keratoconus is a non-inflammatory corneal ectatic disorder characterized by progressive corneal thinning and ectasia, leading to irregular astigmatism and visual impairment. Rigid gas permeable (RGP) contact lenses are often prescribed to manage keratoconus; however, improper use can lead to complications such as infectious keratitis. Case presentation: We present a case of a 25-year-old female with keratoconus who developed infectious keratitis after three months of RGP lens wear. The patient presented with ocular discomfort, pain, photophobia, and redness in the left eye. Clinical examination revealed conjunctival and ciliary injection, a paracentral corneal infiltrate, and decreased visual acuity. Corneal pachymetry confirmed bilateral corneal thinning. The patient was diagnosed with bilateral keratoconus, bilateral compound myopic astigmatism, and left-eye infectious keratitis. Treatment included discontinuation of RGP lens wear, topical antibiotic therapy, and artificial tears. After two weeks of treatment, the corneal infiltrate resolved, and the patient was allowed to resume RGP lens wear with strict adherence to hygiene protocols. Conclusion: This case underscores the importance of patient education and meticulous lens hygiene in preventing infectious keratitis and other complications associated with RGP lens wear in keratoconus patients. Regular follow-up examinations are crucial to monitor for signs of complications and ensure optimal lens fit. By adhering to these guidelines, clinicians can help to ensure the safe and effective use of RGP lenses in keratoconus patients

    Diagnostic Roles of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Vertebral Fracture due to Tuberculosis and Malignancy

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    Background: Vertebral fracture is a serious complication that can occur due to various medical conditions, including bone tuberculosis and malignancy (eg, cancer metastasis to the vertebrae). This condition invariably causes an increase in the inflammatory process in the body, which can be identified through the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR). This study aims to investigate the differences in NLR and PLR values in patients with vertebral fractures due to TB or malignancy. Methods: A retrospective observational study was conducted on vertebral fracture patients who underwent surgery in the Orthopedic Surgery Department of Dr. Kariadi Hospital Semarang between January 1st, 2022, and December 31st, 2023. Data on demographics and laboratory test results were extracted from medical records. Statistical analysis was performed using univariate analysis and presented as percentage and frequency. T-test or Mann-Whitney test was used to determine the difference based on their normality distribution. The diagnostic value of NLR and PLR was also analyzed using the receiver operating characteristic (ROC) curve and Youden index. Results: The study included 54 vertebral fracture patients. The mean age of patients was 41.77 ± 16.00 years, and the majority were female patients (68.5%). The Neutrophil to Lymphocyte Ratio (NLR) value was significantly higher in vertebral fracture due to malignancy patients than TB (5.5 (IQR 3.92 – 13.39) vs 4.53 (IQR 2.91 – 6.96), p=0.020). In contrast, the Platelet to Lymphocyte Ratio (PLR) value was not significantly different (p>0.05). The area under the curve for the NLR (0.69, 95% confidence interval [CI], 0.54 – 0.839) was greater than that of PLR (0.408, 95% CI, 0.246 – 0.571). Conclusion: NLR showed significantly different results in determining the cause of vertebral fractures, either tuberculosis or malignancy. NLR can be used as an important diagnostic marker to help differentiate between vertebral fractures caused by malignancy and those caused by infection

    Recurrent Giant Parasagittal Meningioma WHO Grade I: A Case Report Highlighting the Challenges of Management and the Role of Molecular Markers

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    Background: Meningiomas are common intracranial tumors, but their recurrence, especially in giant parasagittal locations, presents significant management challenges. This case report underscores these challenges and emphasizes the potential role of molecular markers in improving prognostication and treatment strategies. Case presentation: A 31-year-old female presented with recurrent giant parasagittal meningioma WHO Grade I. She underwent multiple surgeries and embolizations due to persistent tumor regrowth despite histologically benign features. The tumor's location, size, and involvement of critical structures posed surgical difficulties, highlighting the limitations of current management approaches. Conclusion: This case emphasizes the need for a more nuanced understanding of meningioma recurrence beyond histological grading. Molecular markers may offer valuable insights into tumor behavior and guide personalized treatment decisions, potentially improving outcomes for patients with recurrent meningiomas

    Does Long-Term Oxygen Therapy Reduce Exacerbations in Chronic Obstructive Pulmonary Disease? A Meta-Analysis

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    Background: Chronic obstructive pulmonary disease (COPD) exacerbations contribute significantly to morbidity, mortality, and healthcare costs. While long-term oxygen therapy (LTOT) is a standard treatment for severe resting hypoxemia in COPD, its impact on exacerbations remains unclear. This meta-analysis aimed to evaluate the effect of LTOT on the frequency and severity of COPD exacerbations. Methods: A systematic search of PubMed, Embase, and Cochrane Library was conducted (January 2018 to December 2023) for randomized controlled trials (RCTs) comparing LTOT to no LTOT in COPD patients. The primary outcome was the rate of moderate to severe COPD exacerbations. Secondary outcomes included hospitalization due to exacerbations and all-cause mortality. The risk of bias was assessed using the Cochrane Risk of Bias tool. A random-effects model was used to pool data, and heterogeneity was assessed using the I² statistic. Results: Nine RCTs with 2,949 participants were included. LTOT was associated with a statistically significant reduction in the rate of moderate to severe exacerbations (Rate Ratio [RR] 0.72; 95% Confidence Interval [CI] 0.67 to 0.78; p < 0.000001), representing an estimated 28% reduction. LTOT also significantly reduced hospitalization for exacerbations (RR 0.69; 95% CI 0.61 to 0.79; p < 0.000001) and all-cause mortality (RR 0.71; 95% CI 0.57 to 0.89; p = 0.003). Conclusion: LTOT significantly reduces the frequency of moderate to severe COPD exacerbations, related hospitalizations, and all-cause mortality. These findings support LTOT use in eligible COPD patients to improve clinical outcomes

    Impact of Hatha and Iyengar Yoga on Physical Function and Quality of Life in Knee Osteoarthritis: A Systematic Review

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    Background: Osteoarthritis (OA) is a chronic degenerative disorder that primarily affects the articular cartilage of synovial joints. This condition leads to pain, joint stiffness, decreased muscle performance, and decreased aerobic capacity, which can negatively impact a patient's quality of life (QOL) and increase their risk of disability. This systematic review aims to investigate the effectiveness of two non-pharmacological treatment regimens, Hatha yoga, and Iyengar yoga, on QOL, physical function, and mental health in patients with knee OA. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive search was performed across three electronic databases: PubMed, Google Scholar, and ScienceDirect, to identify eligible studies that examined the beneficial effects of Hatha Yoga and Iyengar Yoga on improving physical function, mental health, and QOL in patients with knee OA. Results: Out of 61 reports initially identified, 51 were excluded based on the pre-defined inclusion and exclusion criteria. The results of this systematic review suggest that the combination of Hatha Yoga and Iyengar Yoga can enhance physical function, mental health, and QOL in patients with knee OA. Conclusion: Both Hatha Yoga and Iyengar Yoga can serve as effective complementary treatments alongside conventional treatment to improve the overall well-being of individuals with knee OA

    Prolonged Hospital Stays in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients: The Role of Comorbid Conditions

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    Background: Continuous ambulatory peritoneal dialysis (CAPD) is a widely used treatment for end-stage renal disease (ESRD), but it is associated with frequent hospitalizations that can significantly impact patients' quality of life and increase healthcare costs. This study aimed to investigate the influence of comorbid conditions on the length of hospital stay (LOS) in CAPD patients. Methods: A retrospective cohort study was conducted on CAPD patients admitted to Dr. Kariadi General Hospital Semarang between January 1st, 2023, and December 31st, 2023. Data on demographics, comorbidities, and LOS were extracted from medical records. The Charlson Comorbidity Index (CCI) was used to assess comorbidity burden. Multivariable linear regression analysis was performed to identify predictors of prolonged LOS, defined as exceeding the median LOS. Results: The study included 52 CAPD patients with a median LOS of 18 days (range: 1-72 days). Patients with comorbidities had a significantly longer LOS compared to those without comorbidities (20.25 ± 12.88 days vs. 12.50 ± 3.63 days, p = 0.045). The presence of comorbidities was significantly associated with prolonged LOS (odds ratio [OR] 2.87, 95% confidence interval [CI] 1.15-7.16, p = 0.023), as were older age (OR 1.05, 95% CI 1.01-1.09, p = 0.012) and peritonitis as the primary reason for hospitalization (OR 3.54, 95% CI 1.38-9.08, p = 0.008). Conclusion: Comorbid conditions are significant contributors to prolonged hospital stays in CAPD patients. These findings underscore the importance of effectively managing comorbidities in this population to optimize healthcare resource utilization and improve patient outcomes

    Ozonated Aloe Vera: A Novel Topical Agent for Improved Wound Healing and Reduced Scar Formation on TGF-β Modulation Invivo Study

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    Background: Chronic wounds and impaired wound healing represent a significant healthcare burden. Aloe vera has been recognized for its therapeutic potential in wound healing, and the combination with ozone, and ozonated aloe vera, may offer synergistic effects. This study investigated the effects of ozonated aloe vera oil on wound healing and scar formation, focusing on TGF-β modulation in a rat model. Methods: Full-thickness skin defects were created on 50 Sprague Dawley rats, which were randomly divided into five groups: (1) control (untreated), (2) aloe vera oil, (3) ozonated aloe vera oil (600 mg/ml ozone), (4) ozonated aloe vera oil (1200 mg/ml ozone), and (5) ozonated aloe vera oil (1800 mg/ml ozone). Wound healing was assessed macroscopically by measuring wound area reduction and microscopically by evaluating TGF-β expression through immunohistochemical staining on days 3, 7, and 14. Results: Ozonated aloe vera oil significantly accelerated wound healing compared to the control and aloe vera oil alone groups (p < 0.05). The highest ozone concentration (1800 mg/ml) showed the most rapid wound closure and the lowest TGF-β expression on day 14 (p < 0.05). Histological analysis revealed enhanced collagen organization and reduced inflammatory cell infiltration in ozonated aloe vera oil treated wounds. Conclusion: Ozonated aloe vera oil effectively promotes wound healing and reduces scar formation in a rat model. The modulation of TGF-β signaling plays a crucial role in these effects. Ozonated aloe vera oil holds promise as a novel topical agent for improved wound management

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    Bioscientia Medicina - Journal of Biomedicine and Translational Research
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