Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Clinical Presentation and Surgical Management of Invasive Ductal Carcinoma Grade III: A Case Report
Get PDFBackground: Invasive ductal carcinoma (IDC) is the most common type of breast cancer, accounting for approximately 80% of all cases. This case report describes the clinical presentation, diagnosis, and surgical management of a 52-year-old female with IDC Grade III.
Case presentation: A 52-year-old female presented with a palpable lump in her left breast, associated with intermittent pain. She had undergone a left breast biopsy excision surgery three months prior. Physical examination revealed a tender mass in the left breast. Imaging studies and histopathological examination confirmed the diagnosis of IDC Grade III. The patient underwent a modified radical mastectomy (MRM).
Conclusion: This case highlights the importance of early detection and prompt surgical intervention in the management of IDC Grade III. MRM remains a cornerstone of treatment for locally advanced breast cancer, offering favorable outcomes and improved quality of life
A Multidisciplinary Approach to Managing Multiple Tuberous Xanthomas in a Pediatric Patient with Familial Hypercholesterolemia Type II: A Rare Case
Get PDFBackground: Familial hypercholesterolemia (FH) is a rare inherited disorder characterized by high cholesterol levels, primarily high levels of low-density lipoprotein cholesterol (LDL-C). This condition can lead to premature cardiovascular disease. A less recognized but significant manifestation of FH is the development of multiple tuberous xanthomas, which are exogenous masses or fatty deposits on the skin.
Case presentation: This report describes the case of a 4-year-old female child who presented to the Dermatology, Venereology, and Aesthetics Department of Dr. M. Djamil General Hospital Padang with multiple yellowish, painless, and non-itchy lumps on her body. These lumps were located on her knuckles, hands, elbows, buttocks, knees, back of knees, ankles, and feet. The lumps had been progressively increasing in size over the past month. Her medical history revealed that she first developed a yellowish lump on her right ankle two years prior, which gradually spread to other areas of her body. A dermoscopic examination showed a yellow-brown structureless area, and laboratory tests confirmed hypercholesterolemia with elevated LDL levels. Her triglycerides were normal, and both of her parents also had hypercholesterolemia. A histopathology examination confirmed the diagnosis of xanthoma. The patient was diagnosed with tuberous xanthomas and treated with simvastatin 1x10 mg, along with surgical excision of the xanthomas and flap reconstruction under general anesthesia.
Conclusion: This case highlights the importance of a multidisciplinary approach in managing multiple tuberous xanthomas in a child with FH. While surgical excision can effectively remove the lesions, ongoing lipid-lowering therapy is crucial to prevent recurrence and reduce cardiovascular risks associated with FH. Collaboration among dermatologists, pediatric cardiologists, and pediatric nutritionists is vital to ensure comprehensive care and enhance the patient's overall quality of life
Multilayered-Amniotic Membrane Transplantation in Gunshot Powder Injury: A Case Report
Get PDFBackground: Amniotic membrane transplantation has been widely used to repair various ocular surface conditions, including inflammatory, infectious, traumatic, and neoplastic conditions, with satisfactory results. a case of a 34-year-old male hit by a gunpowder explosion.
Case presentation: We reported a case of a 34-year-old male hit by a gunpowder explosion. The right eye was hyperemic and felt blurry after the incident. On examination of the right eye, visual acuity was 20/150, and foreign bodies and erosion were found in the cornea. The patient planned to do foreign body extraction followed by a multilayered-amniotic membrane transplantation (ML-AMT) procedure. On the first and second day of follow-up, on the right eye, the visual acuity was 1/300, palpebral edema was decreased, and subconjunctival hemorrhage was found. On the cornea, there were ML-AMT and bandage contact lenses.
Conclusion: Gunshot powder injury in the eyes is quite rare. The damage that can occur ranges from corneal epithelium abrasion to perforation and rupture of the eyeball. AMT has been successfully used in the management of eye trauma with defects on the ocular surface
Recurrent Genital Herpes and Balanoposthitis Candidiasis in Men with Incomplete Circumcision: A Case Report
Get PDFBackground: Circumcision can reduce the risk of sexually transmitted diseases (STDs). It may reduce males acquiring HSV-2 by 30% and 68% lower prevalence of balanitis than uncircumcised males. There is no report of incomplete circumcision as a risk for STD infection.
Case presentation: A 31-year-old male complained of multiple ulcers that covered a yellowish crust on the penile with a burning sensation since 7 days ago. Initially, it was vesicles that turned into ulcers. One month ago, he complained of moist scales on his preputium that felt itchy and smelly. The patient is married and sexually active. History of intercourse with female sex workers without condoms 2 weeks ago. The patient had incomplete circumcision when he was a child; the preputium is still persistent and seldom cleaned regularly. One year ago, there was a history of vesicles on the penis. Physical examination revealed obesity grade 2. Venereological findings showed a whitish pseudo-membrane on the preputium, glans penis, and ulcers in various sizes covered pseudo-membrane surrounded erythema oedema. Laboratory revealed positive IgG HSV1, IgM, and IgG HSV2. A fungal culture is positive candida. Diagnosis established as recurrent genital herpes, balanoposthitis candidiasis, non-specific genital infection, candidiasis intertrigo. The patient has persistent preputium as the entry of commensal pathogens through abrasions in the mucosa, which causes infection. The patient had complete resolution after being administered oral acyclovir, doxycycline, and topical miconazole.
Conclusion: Persistent preputium in incomplete circumcision is a risk for developing candidiasis, balanoposthitis, and recurrent genital herpes
Correlation Between APGAR Scores and the Incidence of Hyperbilirubinemia in Neonates at Wangaya Regional General Hospital, Denpasar
Get PDFBackground: Hyperbilirubinemia is defined as total serum bilirubin level at ≥ 5 mg/dl. In Indonesia, the prevalence of jaundice is 13,7-85%. One of the risk factors for hyperbilirubinemia in neonates is babies born with a history of asphyxia. The diagnosis of asphyxia can be enforced by the APGAR scoring system. This study aims to determine the relationship between APGAR values and the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital.
Methods: This research is an analytic observational study using a cross-sectional approach, which was carried out in April-May 2022. The sample was taken by consecutive sampling. Bivariate analysis was performed using the chi-square test. Confounding variables will be controlled by design and by analysis. Influential risk factors were analyzed multivariate with logistic regression. Data were analyzed with SPSS software.
Results: From 84 samples, 67, 9% had hyperbilirubinemia. The 1-minute APGAR score (P = 0,017, OR = 8,373, 95% CI; 1,468 – 47,738) and the 5-minute APGAR score (P = 0,034, OR =8,680, 95% CI; 1,172 – 64, 293) had significant correlation with the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital.
Conclusion: Low APGAR scores have a significant correlation with the incidence of hyperbilirubinemia in neonates treated at Wangaya Regional General Hospital. The factor that most influences the incidence of hyperbilirubinemia is the 1-minute APGAR score. Neonates born with a low 1-minute APGAR score are 8,3 times at risk of experiencing hyperbilirubinemia
Nephrotic Syndrome in a 24-Year-Old Female with Myelodysplastic Syndrome: A Case Report
Get PDFBackground: Nephrotic syndrome is rare in the normal population but is reported more frequently in patients with myelodysplastic syndrome (MDS). The pathogenesis is not clearly known, but it is thought to be related to immune dysregulation.
Case presentation: We report a case of nephrotic syndrome in a 24-year-old woman with MDS. Patients complain of swelling, foamy urination, paleness, weakness, bleeding gums, and reddish spots on the body. Physical examination revealed hypertension, anemia, petechiae, and edema. Laboratory examination showed anemia, thrombocytopenia, hypoalbuminemia, dyslipidemia, and proteinuria. Abdominal ultrasound showed chronic processes in the kidneys, ascites, and pleural effusion. A renal biopsy showed membranoproliferative glomerulonephritis.
Conclusion: Nephrotic syndrome in MDS patients is rarely reported, and its pathogenesis is still not clearly understood. Further research is needed to understand the pathogenesis and optimal therapeutic options
Analysis of Risk Factors for Increased Intraocular Pressure in Phacoemulsification Surgery: Single Center Study in Jakarta, Indonesia
Get PDFBackground: Phacoemulsification, a common cataract surgery technique, can increase intraocular pressure (IOP) postoperatively. This study aimed to identify risk factors contributing to increased IOP, focusing on patient age and duration of phacoemulsification.
Methods: A cross-sectional study was conducted at Harapan Jayakarta Hospital, Jakarta, for 4 months (May-September 2023) on 43 cataract patients ≥40 years old who underwent phacoemulsification. Inclusion criteria were preoperative IOP 10-21 mmHg, clear conjunctival and corneal structures. Data analysis was carried out univariate and bivariate using SPSS.
Results: Analysis showed a significant correlation between patient age and phacoemulsification duration (older patients = longer phacoemulsification time), with a mean age of 63.21 years. Phacoemulsification duration >270 seconds significantly increases the risk of postoperative IOP.
Conclusion: Prolonged exposure to ultrasonic waves during phacoemulsification can cause cellular injury to the internal structures of the eye, increasing IOP. Identifying modifiable risk factors, such as optimizing phacoemulsification timing, may reduce these complications and improve cataract surgery outcomes
Ketogenic Keys to Body Composition: Nutritional Insights and Comparative Dietary Effects
Get PDFBackground: The ketogenic diet, characterized by high fat, low carbohydrate intake, has garnered significant interest for its impact on body composition. Despite its popularity, the mechanisms and long-term effects of the diet remain subjects of ongoing research and debate within the medical and nutritional science communities.
Methods: This review systematically examines peer-reviewed clinical trials, observational studies, and comparative analyses conducted from 2004 to 2024. Studies were selected based on their relevance to the ketogenic diet's effects on body composition, adherence to rigorous methodological standards, and the provision of clear outcome measures related to fat mass, lean muscle mass, and overall weight changes.
Results: The review synthesizes findings to elucidate the diet's mechanisms, effects, and comparative performance against other dietary interventions. The ketogenic diet induces metabolic adaptations conducive to fat loss while potentially preserving lean muscle mass, mediated through ketosis and associated hormonal shifts. Comparative analyses suggest that the ketogenic diet may offer distinct advantages in fat reduction compared to low-fat and Mediterranean diets, attributed to its profound effects on metabolic pathways and satiety regulation. However, individual responses vary significantly, influenced by factors such as exercise, diet duration, macronutrient composition, and genetic predispositions.
Conclusion: The ketogenic diet emerges as a potent intervention for altering body composition, particularly effective in reducing fat mass. Its unique metabolic and hormonal effects distinguish it from other dietary approaches. Nevertheless, considerations regarding the diet's long-term sustainability, potential risks, and individual variability underscore the need for personalized dietary planning and further research
IgA Nephropathy and Lupus Nephritis in a 17-Year-Old Female: A Case Report
Get PDFBackground: Acute nephritic syndrome is classically presented with proteinuria, haematuria, azotemia, red blood casts, oliguria, and hypertension (PHARAOH) occurring acutely. Extensive inflammation of the glomeruli causes a decrease in the glomerular filtration rate so that it will produce uremic symptoms such as water and salt retention which will give a clinical picture of edema and hypertension, positive protein in the urine, the presence of erythrocytes or the appearance of dysmorphic erythrocytes in the urine.
Case presentation: A 17 year old female with nephritic syndrome is reported to have nephritic lupus and IgA nephropathy. He has been treated with corticosteroids, immunosuppressants, antihypertensives, and also diuretics followed by progress of clinical and laboratory conditions. Biopsy has been performed to provide a definitive diagnosis in the patient and determine the type of nephritic syndrome experienced. The biopsy showed features of IgA nephropathy (IgAN) and lupus nephritis.
Conclusion: Nephritic syndrome has been suspected due to the presence of haematuria, proteinuria, eyelid swelling, and hypertension. The management given to patients is supportive and symptomatic. Long-term administration of corticosteroids is needed in the treatment of nephritic syndrome as a maintenance therapy. Observation during treatment is needed to assess improvement or worsening of the disease experienced
The Role of Tecovirimat in the Management of Monkeypox
Get PDFMonkeypox is a self-limited disease with symptoms that disappear within 14 to 21 days. Clinical management of monkeypox includes general supportive care and the use of antivirals that have activity against the monkeypox virus. This literature study aims to describe the role of tecovirimat in the management of monkeypox. Tecovirimat is an antiviral drug approved by the U.S. Food and Drug Administration (FDA) as part of the treatment management of smallpox in adults and children. Evidence of the efficacy of tecovirimat as mpox therapy was obtained from animal studies, where tecovirimat reduced mortality rates, reduced duration of illness and viral shedding. Tecovirimat inhibits the vp37 viral protein encoded by the F13 gene of the variola virus. This protein is highly conserved in orthopoxviruses, allowing tecovirimat to have in vitro activity against several orthopoxviruses, including vaccinia, variola, cowpox, and monkeypox viruses. In conclusion, tecovirimat is used in monkeypox sufferers with severe clinical conditions (sepsis, encephalitis, extensive lesions, bleeding manifestations), patients at risk of experiencing severe clinical conditions (immunocompromised, pregnant or breastfeeding, history of psoriasis, varicella zoster infection) and patients with one or more complications