Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Correlation between Troponin I Levels and Location of Acute Myocardial Infarction in ST-Elevation Myocardial Infarction Patients
Get PDFBackground: Acute myocardial infarction (AMI) remains a leading cause of mortality in Indonesia. Cardiac troponin I (cTnI) is a highly sensitive and specific biomarker for AMI, and its levels may correlate with infarct location and prognosis. This study investigated the relationship between cTnI levels and the location of myocardial infarction in ST-elevation myocardial infarction (STEMI) patients.
Methods: A cross-sectional study was conducted on 57 STEMI patients admitted to H. Abdul Manap Regional General Hospital in Jambi City from April 2022 to 2024. Patients were consecutively enrolled based on inclusion and exclusion criteria. cTnI levels were measured using a point-of-care testing (POCT) device. The correlation between cTnI levels and infarct location was analyzed using the Pearson correlation test.
Results: The majority of patients were male (78.49%). The highest incidence of AMI was observed in the anterolateral location, with an average cTnI level of 12.16 ng/ml. A strong positive correlation was found between cTnI levels and the location of infarction (r = 0.891, p < 0.05).
Conclusion: Higher cTnI levels are associated with specific AMI locations, particularly anterolateral infarctions. This finding highlights the importance of cTnI measurement in assessing AMI severity and potential prognosis
Profile of Urticaria and Angioedema Patients at Dr. Moewardi General Hospital Surakarta, Indonesia
Get PDFBackground: Urticaria is a heterogeneous inflammatory skin disease that results from the activation and degranulation of cutaneous mast cells, followed by the release of histamine and other mediators that cause sensory nerve activation, vasodilation, plasma extravasation, and recruitment of immune cells. The prevalence and incidence of urticaria and angioedema have been extensively studied worldwide, but there is still limited data in Indonesia, especially regarding the profile of urticaria and angioedema patients. The purpose of this study was to determine the profile of urticaria and angioedema patients at Dr. Moewardi General Hospital for the period January 1st, 2020 - December 31st, 2022.
Methods: This study is a cross-sectional retrospective study with secondary data derived from medical records of urticaria and angioedema patients.
Results: There were 152 patients with urticaria, most of whom were in the age group >60 years (20.39%), female with a male to female ratio of 1:1.92, and worked as housewives (17.76%) and students (16.45%). Most cases were diagnosed with urticaria (86.84%) with some patients having angioedema (13.16%). The most common comorbidities rhinoconjunctivitis (2.63%), atopic dermatitis (1.97%) and asthma (1.32%). The dominant symptoms were itching and bumps (100%). The main treatment received by patients was single AH1 (71.71%) followed by combination therapy of AH1 and systemic corticosteroids (14.47%), combination therapy of AH1 and topical corticosteroids (10.53%), and the rest received combination therapy of AH1, topical corticosteroids, and systemic corticosteroids (3.29%). The skin prick test was positive in 16 patients (35.56%), with the most common allergens found being peanut (37.5%), egg yolk (37.5%), and tomato (37.5%).
Conclusion: The characteristics of urticaria patients were dominated by elderly patients, female gender, and working as housewives or not working. Patients were predominantly diagnosed with urticaria with the most common comorbidities being diabetes mellitus. The main treatment received was AH1 class drugs. The most common types of allergens identified were peanuts, egg yolks, and tomatoes
Differences in Mean Anti-Pertussis Antibody Levels in Children with Acellular Pertussis Immunization and Whole Pertussis Without Booster
Get PDFBackground: The incidence of pertussis is increasing every year, especially in developing countries. Low immunization coverage and decreased immunity are some of the factors causing the re-increase in pertussis cases. The protection provided by the pertussis vaccine whole and acellular pertussis given as a baby will decrease with age. This study aims to determine the difference in mean levels of anti-pertussis antibodies in children who received acellular pertussis and whole pertussis immunization without a booster.
Methods: A cross-sectional study was carried out at the pediatric polyclinic of Dr. M. Djamil General Hospital Padang from December 2022 to December 2023. Research subjects were children aged 5-9 years with a history of whole pertussis immunization (DPwT) 3 times or acellular pertussis immunization (DPaT) 3 times. The research subjects were examined for anti-pertussis antibody titers using the ELISA technique.
Results: Thirty-four children with a history of DPwT immunization 3 times and 34 children with a history of DPwT immunization 3 times were research subjects, with mean age 6.94±1.49 in the DPwT group and 6.88 ±1.61 in the DPaT group. The mean anti-pertussis antibody level in the DPwT group (9.54 IU/mL) was higher than the DPaT group (6.96 IU/mL) but was not statistically significant (p>0.05). The average antibody results showed that the antibody levels in both groups were below the antibody titer threshold that provides protection against pertussis. The results of the analysis showed that there was a significant difference in the incidence of AEFI between the DPwT and DPaT immunization groups (p<0.05).
Conclusion: There was no difference in anti-pertussis antibody levels in children who received DPwT and DPaT immunization 3 times. Pertussis immunization is a required booster so that antibody levels are sufficient to provide protection against pertussis
Collecting Duct Carcinoma in the Kidneys: A Rare Case Report
Get PDFBackground: Collecting duct carcinoma (CDC) is one of the rare pathological subtypes of renal cell carcinoma, with high malignancy and poor prognosis. Pathological examination is the gold standard in confirming the diagnosis of CDC. CDC is described as a tumor that has a tubulopapillary architecture and forms a hobnail pattern along the glandular tube.
Case presentation: A 56-year-old woman with the main complaint of a lump in the right abdomen for 1.5 months before entering the hospital. The lump in the stomach is getting bigger, complaints are accompanied by intermittent pain, nausea, vomiting, body feeling weak, and decreased appetite. The patient then underwent a CT-Scan examination of the abdomen and concluded that fluid/water was found next to the right kidney, and a hypodense lesion appeared in segment 6 of the right lobe of the liver. Histopathological examination of large tissue shows pieces of kidney tissue with a connective tissue capsule on the outside containing glomeruli and tubules lined by cuboidal epithelium as well as a proliferation of tumor cells that grow infiltratively in the connective tissue stroma which is partly desmoplastic and fatty tissue between the glomeruli and tubules. Tumor cells are arranged to form tubulopapillary and tubulocystic structures. These cells with pleomorphic nuclei, some hyperchromatic, some vesicular, coarse chromatin, clear nuclei, and atypical mitoses can be found and tumor cell embolism in the blood vessels and perineural invasion can be seen. There were spots and clusters of lymphocytes and plasma cells as well as areas of bleeding and necrosis.
Conclusion: The patient was diagnosed with collecting duct carcinoma (CDC)
The Role of Ferritin Levels on Vitamin D Status in Pregnant Women: An Observational Single Center Study at Hermina Hospital, Padang, Indonesia
Get PDFBackground: Vitamin D deficiency during pregnancy is associated with poor pregnancy outcomes. Research shows a complex interaction between iron and vitamin D. Pregnant women are susceptible to iron deficiency due to increased iron requirements during pregnancy. Ferritin reflects body iron stores and may decrease before serum iron. This study aims to analyze the relationship between ferritin levels and vitamin D status in pregnant women.
Methods: This retrospective comparative cross-sectional analytical observational study involved pregnant women in the 1st, 2nd, and 3rd trimesters who underwent antenatal care at Hermina Hospital Padang from February to August 2023. Vitamin D (25(OH)D3) and ferritin were measured using enzyme-linked fluorescence assay (ELFA). Univariate and bivariate analysis used the Chi-square and odds ratio (OR) tests, with a significance of p<0.05.
Results: Of 163 pregnant women (mean age 30.4 years), median ferritin levels were 25.85 ng/mL and 25(OH)D3 15.5 ng/mL. Low ferritin was found in 63.80% of subjects and sufficient vitamin D in 31.90%, insufficiency in 33.74%, and deficiency in 34.36%. There was no correlation between low ferritin and vitamin D insufficiency (OR=2.04; 95% CI 0.94-4.42; p=0.700). However, there was a significant correlation between low ferritin and vitamin D deficiency (OR=6.59; 95% CI 2.68-16.18; p=0.000).
Conclusion: Pregnant women with low ferritin have a 6.59 times higher risk of experiencing vitamin D deficiency
Analysis of Risk Factors and Body Mass Index Against Degrees of Severity of Psoriasis Vulgaris
Get PDFBackground: Psoriasis vulgaris (PV) is a chronic inflammatory skin disease with a multifactorial etiology, including genetic, immunological, and environmental factors. Obesity, characterized by a high body mass index (BMI), has been increasingly recognized as a potential risk factor for PV and may influence its severity. This study aimed to analyze the relationship between various risk factors, particularly BMI, and the severity of PV.
Methods: A cross-sectional study was conducted at a dermatology outpatient clinic of Dr. Moewardi Surakarta Hospital. Patients with a confirmed PV diagnosis were enrolled. Demographic data, medical history, lifestyle factors (smoking, alcohol consumption), and anthropometric measurements (height, weight, BMI) were collected. PV severity was assessed using the psoriasis area and severity index (PASI). Statistical analysis, including univariate and multivariate logistic regression, was performed to identify associations between risk factors and PV severity.
Results: The study included 200 PV patients with a mean age of 45.2 years (SD = 12.8) and a male predominance (58%). The mean PASI score was 12.4 (SD = 8.6), indicating a wide range of disease severity. Multivariate analysis revealed that obesity (BMI ≥ 30 kg/m2) was significantly associated with increased PV severity (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.5-5.2, p = 0.001). Smoking (OR = 1.9, 95% CI = 1.1-3.3, p = 0.02) and a family history of psoriasis (OR = 2.3, 95% CI = 1.3-4.1, p = 0.004) were also identified as independent risk factors for higher PASI scores. Alcohol consumption showed a borderline association with increased severity (OR = 1.6, 95% CI = 1.0-2.6, p = 0.05).
Conclusion: Obesity, smoking, and a family history of psoriasis are significant risk factors for increased PV severity. These findings underscore the importance of addressing modifiable risk factors, such as weight management and smoking cessation, in the holistic management of PV. Further research is warranted to elucidate the underlying mechanisms linking these risk factors to PV severity and to develop targeted interventions to improve patient outcomes
Effectiveness of Dipeptidyl Peptidase IV Inhibitors in the Management of Chronic Obstructive Pulmonary Disease: A Meta-Analysis
Get PDFBackground: Chronic obstructive pulmonary disease (COPD) is a major global health issue. Recent research suggests dipeptidyl peptidase IV (DPP-IV) inhibitors, primarily used in diabetes management, may have beneficial effects on lung function and inflammation in COPD. This meta-analysis aims to assess the efficacy and safety of DPP-IV inhibitors in COPD.
Methods: A systematic search of PubMed, Embase, and Cochrane Library databases was conducted from January 2018 to June 2024. Randomized controlled trials (RCTs) comparing DPP-IV inhibitors with placebo or standard COPD therapy in patients with COPD were included. Data on lung function (FEV1), quality of life, exacerbations, and adverse events were extracted. Meta-analyses were performed using random-effects models.
Results: Ten RCTs involving 4,520 patients were included. DPP-IV inhibitors were associated with a significant improvement in FEV1 compared to placebo or standard therapy (mean difference: 55 ml, 95% CI: 30-80 ml, p<0.001). Quality of life scores also showed a trend toward improvement. The rate of moderate-to-severe exacerbations was significantly lower in the DPP-IV group (risk ratio: 0.75, 95% CI: 0.60-0.93, p=0.008). Adverse events were similar between groups.
Conclusion: DPP-IV inhibitors may be a promising adjunctive therapy in COPD management, improving lung function, and quality of life, and reducing exacerbations. Further research is warranted to confirm these findings and investigate long-term effects
Effectiveness of Airway Management Strategies in Critically Ill Patients: A Meta-Analysis
Get PDFBackground: Airway management is a cornerstone of critical care, but the optimal strategies for critically ill patients remain debated. This meta-analysis aimed to evaluate the effectiveness of various airway management techniques in critically ill patients.
Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted from January 2018 to December 2023. Studies comparing different airway management strategies (e.g., endotracheal intubation, laryngeal mask airway, video laryngoscopy) in critically ill adults were included. Primary outcomes were successful airway establishment, time to airway securement, and complications (e.g., hypoxia, aspiration). Meta-analyses were performed using random-effects models, and the risk of bias was assessed.
Results: Twenty-three studies (n=5,894 patients) were included. Video laryngoscopy was associated with a higher success rate of first-pass intubation compared to direct laryngoscopy (OR 1.85, 95% CI 1.43-2.40, p<0.001). No significant differences were found in overall complications between video laryngoscopy and direct laryngoscopy (OR 0.92, 95% CI 0.68-1.24, p=0.59). In patients with difficult airways, video laryngoscopy demonstrated a reduced risk of complications compared to direct laryngoscopy (OR 0.63, 95% CI 0.41-0.97, p=0.04).
Conclusion: Video laryngoscopy is a safe and effective alternative to direct laryngoscopy, particularly in critically ill patients with predicted difficult airways. Further research is needed to determine the optimal airway management strategy in specific subgroups of critically ill patients
Passive Smoking as a Significant Risk Factor of Cervical Dysplasia: A Novel Findings in Single Center Study in Denpasar, Bali, Indonesia
Get PDFBackground: Colposcopy is a diagnostic procedure evaluating the cervix following an abnormal screening test. It aims to identify and treat cervical cancer precursors. Risk stratification at the end of colposcopy helps differentiate those who can return to regular screening from those needing more frequent screening or surveillance. The study examined the characteristics and risk factors of patients undergoing colposcopy for cervical dysplasia in Denpasar, Bali, Indonesia.
Methods: This was a cross-sectional study of women who underwent colposcopy at BaliMed Hospital, Denpasar, Bali, Indonesia, from January 2021-December 2022. Data were derived from medical records. The gynecology oncologist performed a colposcopy examination with a biopsy sample, which was later checked by the pathologist. Bivariate and multivariate analyses were used to identify the risk factors associated with cervical dysplasia.
Results: 142 patients underwent colposcopy with a mean age of 37.28+10.1 years. Seventy-eight patients (54.9%) had a low-grade cervical lesion, and 9 (6.3%) had a high-grade cervical lesion. After adjusting the employment status and education level, factors associated with cervical dysplasia were age at first intercourse <20 years (aOR [adjusted odd ratio] 2.44, 95% CI [1.04-5.69]) and history of smoking, either actively or passively (aOR 8.91, 95% CI [3.52-22.54]). From the biopsy result, patients with abnormal cervical lesions were associated with evidence of CIN (aOR 9.03, 95% CI [2.49-32.77]).
Conclusion: Early age first sexual intercourse and history of smoking have been identified as significant risk factors for cervical dysplasia. Additionally, passive smoking has been shown to increase the risk. This research provides a foundational reference for future studies in this area
Successful Management of Miliary Tuberculosis with Concomitant Anemia: A Case Report
Get PDFBackground: Miliary tuberculosis (TB) is a disseminated and potentially fatal form of TB characterized by the hematogenous spread of Mycobacterium tuberculosis, often complicated by anemia of chronic disease. The diagnosis and management of miliary TB, particularly in conjunction with anemia, can be challenging, especially in resource-limited settings.
Case presentation: We report the case of a 20-year-old male from a remote region in Eastern Halmahera, Indonesia, who presented with progressive shortness of breath, productive cough, night sweats, unintentional weight loss, and generalized weakness. Clinical examination revealed signs of anemia and respiratory distress. Laboratory investigations confirmed microcytic hypochromic anemia and a positive GeneXpert MTB/RIF test. Chest radiography demonstrated diffuse miliary nodules, consolidation, and cavitation, establishing the diagnosis of miliary TB with concomitant anemia. The patient received a standard six-month anti-tuberculosis therapy regimen, along with supportive care and targeted treatment for anemia and associated symptoms. The patient demonstrated significant clinical and hematological improvement, leading to discharge after 11 days of hospitalization. Follow-up assessments confirmed continued progress and the absence of complications.
Conclusion: This case underscores the critical importance of maintaining a high index of suspicion for miliary TB in patients presenting with respiratory and constitutional symptoms, even in the absence of traditional risk factors. The presence of anemia can further complicate the clinical picture. Prompt diagnosis through a combination of clinical assessment, laboratory investigations, and imaging studies, followed by the immediate initiation of appropriate treatment, including the management of anemia, is paramount for achieving favorable outcomes in patients with miliary TB. The case also emphasizes the necessity for comprehensive care and follow-up to ensure sustained recovery and prevent relapse