Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Intralesional Mumps, Measles, Rubella (MMR) Vaccine as Therapy for Recurrent Condyloma Acuminata: A Case Report
Get PDFBackground: Condyloma acuminata (CA), a prevalent sexually transmitted infection caused by the human papillomavirus (HPV), presents challenges in treatment due to its high recurrence rate. While various treatment modalities exist, intralesional immunotherapy with the mumps, measles, rubella (MMR) vaccine has shown promise in managing HPV-related conditions. This case report investigates intralesional MMR vaccine in treating recurrent CA.
Case presentation: A 24-year-old female presented with recurrent CA lesions on the labia majora and perianal region. Despite prior treatment with trichloroacetic acid (TCA), the lesions had reappeared. Intralesional MMR vaccine injections were administered twice, one month apart, resulting in complete lesion resolution within six weeks of the second injection. No recurrence was observed during a six-month follow-up period, and the patient reported only mild, transient pain at the injection sites.
Conclusion: This case report highlights the potential of intralesional MMR vaccine as an effective and well-tolerated treatment option for recurrent CA. Further research is warranted to validate these findings and establish optimal treatment protocols
Premature Rupture of Membranes in a Pregnant Patient with Systemic Lupus Erythematosus and Lupus Carditis: A Case Report
Get PDFBackground: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease associated with significant maternal and fetal risks, especially during pregnancy. Lupus carditis and premature rupture of membranes (PROM) pose additional challenges in managing such pregnancies.
Case presentation: A 21-year-old woman with a history of SLE and lupus carditis presented at 34 weeks gestation with premature rupture of membranes. Her medical history was notable for regular follow-up and treatment for SLE manifestations, including mucocutaneous involvement and microcytic hypochromic anemia. Physical examination revealed characteristic signs of SLE, and echocardiography confirmed dilated cardiomyopathy. Following a multidisciplinary approach, a cesarean section was performed, resulting in the successful delivery of a healthy neonate.
Conclusion: This case highlights the importance of a coordinated multidisciplinary approach in managing complex pregnancies involving SLE, lupus carditis, and PROM. Early diagnosis, close monitoring, and timely intervention are crucial for optimizing maternal and fetal outcomes in such cases
Case of Hypopigmented Mycosis Fungoides: Clinical and Pathological Discrimination from Mimicking Conditions
Get PDFBackground: Hypopigmented mycosis fungoides (HMF) is an uncommon variant of mycosis fungoides (MF), a cutaneous T-cell lymphoma. It presents a diagnostic challenge due to its clinical resemblance to various benign dermatological conditions. This case report highlights the importance of a comprehensive approach to diagnosis, incorporating clinical, histopathological, and immunohistochemical findings.
Case presentation: A 48-year-old Indonesian woman presented with a one-year history of progressive, asymptomatic hypopigmented patches on her extremities. Initially misdiagnosed as progressive macular hypomelanosis, the patient's condition did not improve with topical treatments. Clinical examination revealed multiple hypopigmented patches and macules on both extremities, with some lesions exhibiting fine scales. Histopathological examination demonstrated atypical lymphocytes with epidermotropism and Pautrier's microabscesses. Immunohistochemical staining confirmed the presence of CD3+ T-cells, leading to the diagnosis of HMF.
Conclusion: HMF can mimic various dermatological conditions, making diagnosis challenging. A thorough clinical assessment, coupled with histopathological and immunohistochemical evaluation, is crucial for accurate diagnosis and appropriate management. This case underscores the importance of considering HMF in the differential diagnosis of hypopigmented skin lesions, particularly in individuals with persistent or atypical presentations. Early recognition and intervention are essential for optimizing patient outcomes
Magnesium of Dead Sea Salts as a Key Factor for the Treatment of Seborrheic and Atopic Dermatitis: A Case Report
Get PDFBackground: Seborrheic and atopic dermatitis are common and chronic inflammatory skin diseases. Conventional treatments are often ineffective and can have significant side effects. Magnesium dead sea salt has a high concentration of magnesium, and previous research shows its potential to help improve skin conditions.
Case presentation: Patients with chronic seborrheic and atopic dermatitis were treated with topical 5% dead sea salt magnesium for 4 days. Patients experienced significant improvement in their symptoms.
Conclusion. Dead Sea salt magnesium can be a safe and effective treatment for seborrheic and atopic dermatitis
Effectiveness of Mechanical Treatments (Periosteal Stripping VS Non-Periosteal Stripping) on Fracture Healing: In Vivo Study
Get PDFBackground: Periosteal stripping (PS) is a controversial technique in fracture management, with studies reporting both positive and negative effects on bone healing. This study aims to evaluate the effectiveness of PS and non-periosteal stripping (NPS) on fracture healing in the Sprague Dawley rat model.
Methods: This study is an in vivo experimental research. Male Sprague Dawley rats (8-10 weeks old) were divided into four groups (n=10 per group): Group I: NPS, evaluation day 14; Group II: PS, evaluation day 14; Group III: NPS, evaluation day 28 and Group IV: PS, evaluation day 28. A standard fracture was created in the tibia, and PS or NPS was performed. Radiographic evaluation was performed on days 14 and 28, with the RUST score (Radiographic Union Score for Tibia) used to assess fracture healing. Statistical analysis was performed using the Kruskal-Wallis test.
Results: The RUST score showed better fracture healing in the NPS group compared to PS on day 28 (p<0.05). There was no significant difference on day 14 (p>0.05).
Conclusion: NPS was more effective in accelerating fracture healing in Sprague Dawley rats than PS, especially in the later stages of healing. These findings provide further evidence of the potential adverse effects of PS and highlight the importance of considering time in assessing its efficacy
Anesthetic Management of a Pediatric Patient with Popliteal Pterygium Syndrome Undergoing Labiopalatoplasty: A Case Report
Get PDFBackground: Popliteal pterygium syndrome (PPS) is a rare congenital disorder characterized by multiple anomalies, including orofacial, musculoskeletal, and genitourinary defects. Airway management in PPS patients can be challenging due to associated craniofacial abnormalities. This case report describes the anesthetic management of a 5-month-old infant with PPS undergoing labiopalatoplasty.
Case presentation: A 5-month-old male infant, weighing 5.9 kg, presented for labiopalatoplasty. He had a diagnosis of PPS with associated labiopalatoschisis, ankyloblepharon filiforme, pterygium in the popliteal fossa, cryptorchidism, and syndactyly. Airway assessment revealed a patent airway with a cleft lip and palate. Anesthesia was induced with sevoflurane and maintained with sevoflurane and nitrous oxide. Direct laryngoscopy was unsuccessful, and videolaryngoscopy was used to facilitate tracheal intubation.
Conclusion: This case highlights the challenges of airway management in infants with PPS. A thorough preoperative airway assessment and the availability of alternative intubation techniques, such as videolaryngoscopy, are crucial for successful anesthetic management in these patients
One and a Half Syndrome and Internuclear Ophthalmoplegia as Neuro-Ophthalmological Manifestations in Patients with Brainstem Stroke: A Case Series
Get PDFBackground: Brainstem stroke syndrome accounts for 10-15% of all types of strokes, which may result in relatively rare neuroophthalmological manifestations. The aim of this case report is to report findings of one and a half syndrome (OAHS) and internuclear ophthalmoplegia in a patient with brainstem stroke.
Case presentation: First case, female, 56 years old, came with sudden weakness on the right side of the body. One and a half syndrome was found, namely when asked to glance to the left, conjugate gaze palsy was obtained horizontally, and when asked to glance to the right, there was adduction inability of the left eye (ipsilateral). Right eye abduction was normal with present nystagmus. Paresis of right central CN. VII, XII was present, along with hemiparesis dextra (contralateral). Head CT scan shows hemorrhage in pons and intraventricular. Second case, female, 65 years old, came with a protruding mouth, vertigo, and sudden double vision Internuclear ophthalmoplegia was present, namely an adduction inability of the left eye (ipsilateral) when asked to glance to the right. Right eye abduction was normal with present nystagmus. no abnormalities were seen in the primary position and when asked to glance to the left. Paresis of right peripheral CN. VII, hemiparesis and right (contralateral) hemihypesthesia was present. MRI shows multiple chronic infarcts as well as subacute infarcts in bilateral parietal and pons.
Conclusion: Clinical knowledge is necessary for topic determination, rehabilitation process and evaluation
Platelet-to-Lymphocyte Ratio as a Potential Diagnostic Marker for Acute Coronary Syndromes in Resource-Limited Settings: A Cross-Sectional Study from Single Center in Banten, Indonesia
Get PDFBackground: Acute coronary syndrome (ACS) poses a significant global health burden, particularly in resource-limited settings where access to advanced diagnostic tools is often constrained. The platelet-to-lymphocyte ratio (PLR), a simple and readily available marker from routine blood tests, has shown promise as a potential diagnostic tool for ACS. This study aimed to evaluate the diagnostic accuracy of PLR in identifying ACS patients in a resource-limited setting in Indonesia.
Methods: A cross-sectional study was conducted at Hermina Periuk Hospital, Tangerang, Banten, Indonesia, between December 2020 and December 2022. Patients presenting to the Emergency Room with a diagnosis of ACS were included. PLR was calculated from complete blood count data, and cardiac troponin I (cTnI) served as the gold standard for ACS diagnosis. The diagnostic performance of PLR in predicting elevated cTnI levels was assessed.
Results: Of the 121 patients initially identified, 39 met the inclusion and exclusion criteria. Elevated PLR values (>116) were observed in 25 patients (64.1%), while 15 patients (38.5%) had elevated cTnI levels. A statistically significant correlation was found between elevated PLR and elevated cTnI (p = 0.018). No significant association was observed between neutrophil-to-lymphocyte ratio (NLR) and elevated cTnI.
Conclusion: PLR demonstrates potential as a diagnostic marker for ACS in resource-limited settings. Its simplicity, accessibility, and cost-effectiveness make it a valuable tool for early identification and risk stratification of ACS patients, particularly in areas with limited access to advanced cardiac diagnostics
The Role of Brain-Derived Neurotrophic Factor (BDNF) in the Pathogenesis of Sarcopenia: A Meta-Analysis of Molecular Mechanisms
Get PDFBackground: Brain-derived neurotrophic factor (BDNF), a neurotrophin crucial for neuronal survival and differentiation, has emerged as a potential key player in sarcopenia development. This meta-analysis aimed to systematically evaluate the molecular mechanisms by which BDNF contributes to sarcopenia.
Methods: A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted for studies published between 2018 and 2024 investigating the relationship between BDNF and sarcopenia at a molecular level. Studies were included if they met the following criteria: (1) examined BDNF signaling pathways in skeletal muscle; (2) assessed the impact of BDNF on muscle protein synthesis/degradation; (3) explored the role of BDNF in mitochondrial function and oxidative stress in muscle; and (4) investigated the influence of BDNF on muscle fiber type and neuromuscular junction integrity.
Results: A total of 28 studies (n = 1,245 participants) met the inclusion criteria. The meta-analysis revealed that lower BDNF levels were significantly associated with: reduced muscle protein synthesis (SMD = -0.85, 95% CI: -1.12 to -0.58, p < 0.001); increased muscle protein degradation (SMD = 0.62, 95% CI: 0.35 to 0.89, p < 0.001); impaired mitochondrial function (SMD = -0.71, 95% CI: -0.98 to -0.44, p < 0.001); increased oxidative stress (SMD = 0.55, 95% CI: 0.28 to 0.82, p < 0.001); a shift towards fast-twitch muscle fibers (SMD = 0.48, 95% CI: 0.21 to 0.75, p = 0.001); and compromised neuromuscular junction integrity (SMD = -0.92, 95% CI: -1.21 to -0.63, p < 0.001).
Conclusion: This meta-analysis provides compelling evidence that BDNF plays a pivotal role in the pathogenesis of sarcopenia through its multifaceted effects on muscle protein metabolism, mitochondrial function, oxidative stress, fiber type composition, and neuromuscular junction integrity
Handgrip Strength: An Early Warning Sign for Mobility Decline? A Meta-Analysis of Diagnostic Accuracy Studies
Get PDFBackground: Mobility limitations significantly impact the quality of life of older adults. Early identification of individuals at risk is crucial for timely intervention. This meta-analysis investigates the diagnostic accuracy of handgrip strength (HGS) in predicting future mobility decline in older adults.
Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for diagnostic accuracy studies published between 2018 and 2024, evaluating the ability of baseline HGS to predict incident mobility limitations in older adults (≥60 years). Mobility limitations were defined as difficulties in performing activities of daily living (ADLs) or instrumental activities of daily living (IADLs). The primary outcomes were sensitivity, specificity, and diagnostic odds ratio (DOR) of HGS for predicting mobility decline. A bivariate random-effects model was used to pool data.
Results: Seven diagnostic studies with a total of 3,870 participants were included. The pooled sensitivity of HGS for predicting mobility decline was 0.72 (95% CI: 0.65-0.78), and the pooled specificity was 0.70 (95% CI: 0.66-0.74). The pooled DOR was 4.85 (95% CI: 3.21-7.32), indicating good discriminatory ability.
Conclusion: This meta-analysis demonstrates that HGS has moderate sensitivity and specificity for predicting future mobility decline in older adults. HGS assessment can be a valuable tool for identifying individuals at risk, although further research is needed to determine optimal cut-off points and combine HGS with other risk factors for improved prediction