Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Relationship between Breast Cancer Subtypes and Serum CA 15-3 Levels with the Incidence of Pleural Effusion in Breast Cancer Patients at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Breast cancer is a disease that has a high incidence rate worldwide. Serum CA 15-3 levels have been used extensively as a tumor marker in breast cancer and can assist in early detection, monitoring of response to therapy, and monitoring of recurrence. This study aimed to evaluate whether there is a relationship between breast cancer subtypes and serum CA 15-3 levels with the incidence of pleural effusion in breast cancer patients at this hospital.
Methods: This study was a cross-sectional observational study. A total of 176 research subjects participated in this study. Analysis of the relationship between breast cancer and CA 15-3 levels with pleural effusion was carried out univariate and bivariate using SPSS version 25.
Results: The results showed that there was a significant relationship between CA 15-3 serum levels and the incidence of pleural effusion in breast cancer patients (p-value = 0.0001). There was no statistically significant relationship between breast cancer subtypes and the incidence of pleural effusion (p-value = 0.105). There was no relationship between serum CA 15-3 levels and the incidence of pleural effusion in breast cancer patients based on breast cancer subtype (p-value> 0.005).
Conclusion: There is a significant relationship between serum levels CA 15-3 serum with the incidence of pleural effusion in breast cancer patients at Dr. M. Djamil General Hospital, Padang, Indonesia
Intensive Strategy Resuscitation of Hemorrhagic Shock Patients with Ectopic Pregnancy in the Intensive Care Unit: A Case Report
Get PDFBackground: Ectopic pregnancy is a health problem in women of reproductive age whose products of conception implant outside the endometrium. Fluid resuscitation and maintenance and adequate treatment in intensive care unit can reduce mortality and morbidity in patients.
Case presentation: A 19-year-old woman came to the emergency department of Dr. M. Djamil General Hospital Padang with complaints of pain in the lower abdomen for 8 hours before entering the hospital. Physical examination results and obtained anemic conjunctiva (+)/(+). Check-up result in deep vaginal touch (VT) was obtained portion rocking pain (+). Then inspection culdosynthesis with results (+). The patient was diagnosed with acute abdominal ec suspected ruptured ectopic pregnancy at G2P1A0H1 gravid 8-9 weeks with severe anemia. After undergoing laparotomy, the patient was admitted to the ICU for 2 days.
Conclusion: Adequate resuscitation of fluids and blood products and overcoming shock causes are crucial in managing hemorrhagic shock in the intensive care unit
Delayed SARS-COV-2 Viral Clearance in a Newly Diagnosed HIV Patient: A Case Series
Get PDFBackground: SARS-CoV-2 can infect anyone, but people with HIV have underlying conditions or comorbidities that can make them seriously ill if infected with SARS-CoV-2. HIV attacks and destroys the immune system delays the response of specific antibodies, and even causes failure to thrive, resulting in a long course of the disease. This case report aimed to describe 2 cases of HIV patients co-infected with SARS-CoV-2 with delayed viral clearance.
Case presentation: There are two HIV patients with co-infection with SARS-CoV-2. The first patient, a 32-year-old man with COVID-19 and HIV-AIDS, was referred from a regional hospital after being treated for 10 days due to clinical deterioration. Physical examination showed that the patient's general condition was moderately ill, and other vital signs were within normal limits. Oral candidiasis was seen in the patient's mouth, crackles were found in both lung fields, and epigastric tenderness was found on abdominal examination. The patient tested positive for COVID-19 based on the results of an antigen swab examination from the previous hospital. The second patient, a 26-year-old man, came with complaints of intermittent fever 1 week before entering the hospital. Complaints began with the body feeling weak and coughing without phlegm 2 weeks ago. The patient tested positive for COVID-19 based on the results of an antigen swab examination. The delayed viral clearance of SARS-CoV-2 in the two patients was possibly caused by the impaired immune response due to HIV infection, as shown by the presence of lymphopenia and decreased CD4+.
Conclusion: ARV use can suppress HIV viral load and increase immunity so that can help viral clearance of SARS-CoV-2
Correlation of the Adverse Event Following Immunization with the Severity of COVID-19 Infection in Health Care Workers in Padang
Get PDFBackground: Effective countermeasures to control the current COVID-19 pandemic are the implementation of health protocols and vaccinations. The problem that must be a concern after vaccination is post-immunization co-occurrence (AEFI), including COVID-19 vaccination. Another issue that is also a concern after vaccination is the incidence of being infected with COVID-19. The purpose of this study was to determine the incidence of post-vaccination COVID-19 infection in health workers in the city of Padang and its association with the incidence of COVID-19 vaccine AEFIs.
Methods: The study used a descriptive-analytic design with a retrospective cohort method. The research will be carried out in all hospitals in Padang, and sampling will be carried out for 2 months, from November to December 2021. Officers who are confirmed to have COVID-19 after vaccination and meet the inclusion criteria are healthcare workers who have received at least 2 vaccines and are willing to fill out a Google form.
Results: The characteristics of health workers in Padang who were confirmed to have COVID-19 after 2 vaccinations were mostly (68.1%) early adults (26-35 years), the sex was mostly female as much as 77.3%, and most professions were workers. Paramedics (nurses or midwives) as much as 57.0%. The most comorbid obesity is as much as 3.4%. Nutritional status assessed by BMI showed that obesity (37.7%) and normal nutritional status (32.9%) had almost the same proportion. Almost all health workers with or without AEFI experience mild COVID-19, as many as 98%, and experience COVID-19 infection 28 days after vaccination.
Conclusion: The incidence of AEFI is not related to the severity of post-vaccination COVID-19 infection in health workers in Padang
Diagnosis and Management of Paraquat Intoxication
Get PDFParaquat poisoning is a clinical toxicological emergency due to the active ingredient of this type of herbicide, gramoxone, with a high mortality rate due to high toxicity, and no antidote has yet been found. Paraquat intoxication can cause multi-organ failure if ingested accidentally or spontaneously because paraquat quickly produces ROS (reactive oxygen species), which causes cell damage through lipid peroxidation, NF-kB activation, mitochondrial damage, and apoptosis in many organs. This results in rapid nephrotoxic and hepatotoxic as well as pulmonary fibrosis. Clinical manifestations depend on the level of paraquat ingested, which can be in the form of local toxicological and systemic toxicological effects. Laboratory tests for diagnosing paraquat toxicity can be used for toxicological analysis of plasma and urine. Management of paraquat intoxication is primarily to remove paraquat from the gastrointestinal tract (prevent absorption) by using activated charcoal, changing the toxicokinetics of the herbicide (increasing serum paraquat elimination) by hemoperfusion and hemodialysis, as well as modifying its toxicodynamics with anti-inflammatory drugs such as immunosuppressants (corticosteroids and cyclophosphamide) and antioxidants (N -acetylcysteine and vitamin C)
Relation between Chronic Rhinosinusitis and Gastroesophageal Reflux in Adults: A Systematic Review
Get PDFBackground: It is not entirely apparent how chronic rhinosinusitis (also known as CRS) develops. Since the 1970s, medical professionals have debated whether or not gastroesophageal reflux (GOR) could be a factor in the development of certain patients' conditions. The purpose of this research is to the relation between chronic rhinosinusitis and gastroesophageal reflux in adults.
Methods: By evaluating the preferred reporting items for systematic review and meta-analysis (PRISMA) 2020 standards, this study demonstrated that it met all of the requirements. This enabled the researchers to ensure that the study was as up to date as feasible. Publications published between 2000 and 2023 were included in the search strategy, which included a variety of electronic reference databases (including Pubmed and SagePub). We did not consider review papers, duplicate publications, or half completed articles.
Results: In the PubMed database, the results of our search brought up 133 articles, whereas the results of our search on SagePub brought up 69 articles. The results of the search conducted for the last year of 2000 yielded a total of 20 articles for PubMed and 8 articles for SagePub. In the end, we compiled a total of 21 papers, six of which came from PubMed and three of which came from SagePub. We included nine research that met the criteria.
Conclusion: According to the findings of most studies, the number of cases of CRS seen in patients with GERD is around two to three times higher than that seen in the general patient group
Symmetric Dimethylarginine as a Biomarker for Chronic Kidney Disease
Get PDFSymmetric dimethylarginine (SDMA), is a post-translationally stable catabolic product of arginine-methylated proteins that plays an important role in basic cellular metabolism. SDMA is an endogenous biomarker of kidney function that has been widely used in veterinary medicine. Symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA) are 2 constant products of L-arginine proteolysis that undergo methylation. SDMA is almost completely excreted by the kidneys after filtration making SDMA an ideal GFR biomarker candidate. Apart from that, SDMA has several advantages as a biomarker of kidney function, namely that it is not affected by non-renal factors that influence creatinine and cystatin C. Apart from that, SDMA also increases earlier than other biomarkers
The Effect of Giving Vitamin D Supplements on Improving Ejection Fraction in Heart Failure Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Get PDFBackground: The role of vitamin D as an inflammation modulator, regulation system renin-angiotensin-aldosterone (RAAS), inhibits the production of parathyroid hormone (PTH), thereby causing left ventricular hypertrophy, causing hypocalcemia which induces hypertrophy in cardiac myocytes and can reduce cardiac contractility. This study aimed to determine the effect of giving vitamin D supplements on improving ejection fraction in heart failure patients at Dr. Mohammad Hoesin General Hospital (RSMH) Palembang, Indonesia.
Methods: This study is an experimental study with a double-blind, randomized clinical trial design and uses primary data obtained from clinical examinations and supporting examinations of research subjects. A total of 40 research subjects participated in this study.
Results: In this study, the median vitamin D level in the vitamin D supplementation group before treatment was 19.92 ng/dl (18.65-20.22), and in the placebo group was 19.74 ng/dl (18.14 - 20.13). After treatment with 1000 iu of vitamin D given for 3 months, the results showed that in the vitamin D supplementation group, there was an increase in vitamin D levels to 33.06 ng/dl (an increase of 13.14) with statistically significant results (p < 0 .05). In the vitamin D supplementation group, there was an increase in ejection fraction to 37.9% (an increase of 3.65%) with statistically significant results (p<0.05). Contrasting results were shown in the group that received a placebo, where there was a decrease in ejection fraction to 33.15% (2.25% decrease).
Conclusion: There is an improving effect of giving vitamin D supplements on increasing ejection fraction in heart failure patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Ileoileal Intussusception Secondary to Meckel's Diverticulum: A Case Report
Get PDFBackground: The most frequently documented aetiology of Meckel's related obstructions is volvulus or intussusception of the small bowel with the presence of Meckel's diverticulum as the lead point. This study presents a case of small bowel obstruction caused by intussusception due to Meckel's diverticulum, which led to an obstruction of the small intestine.
Case presentation: A 17-year-old male patient visited the hospital's emergency room complaining of worsening abdomen pain for two days. It was associated with abdominal distention, fever, nausea, and vomiting. There was no roving's sign or psoas sign and no rebound tenderness. There is no history of gastrointestinal cancer in his family or previous abdominal surgery. The white blood cell count was 18,400 c/mm, and the electrolytes, liver function tests (LFTs), and urinalysis were all within normal ranges. Ultrasonography imaging of right lower quadrant (RLQ): thickening tubular structure with target sign view and enteric intussusception with the possibility of appendix component.
Conclusion: A 17-year-old male went to the emergency room complaining of acute abdominal pain and was diagnosed with ileoileal intussusception intraoperatively
Risk Factors of In-Hospital Mortality of Ischemic Stroke Patients in Gunung Jati General Hospital
Get PDFBackground: Stroke is the leading cause of death and the most significant contributor to disabilities worldwide. Predicting the mortality of stroke patients and giving optimal care remain challenges in developing countries like Indonesia. In this study, we aimed to identify factors associated with in-hospital mortality after acute ischemic stroke.
Methods: The study conducted a retrospective cohort of cerebral infarct patients administered in 2022 to Gunung Jati General Hospital, West Java, Indonesia. This study included hospitalized patients with a clinical history of stroke confirmed by a CT scan or MRI. The clinical data, radiology, and laboratory tests were collected at admission or within 24 hours after admission.
Results: This study involved a total of 92 ischemic stroke patients with a median age of 62. The most prevalent comorbidities were dyslipidemia (93.5%), hypertension (83.7% of patients), and concomitant infection (50%). Patients who experienced in-hospital mortality had a significantly higher number of comorbidities, such as chronic kidney disease, concomitant infection, and atrial fibrillation. Statistically higher neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were also shown in non-survived patients. Ischemic stroke patients with concomitant infection and atrial fibrillation, respectively, had 6.679 (aOR: 6.679, 95% CI 1.802-27.029) and 6.904 times (aOR: 6.904, 95% CI 1.290-36.959) greater to have in-hospital mortality.
Conclusion: Concomitant infection and atrial fibrillation were associated with in-hospital mortality in ischemic stroke patients at Gunung Jati General Hospital. The findings indicated the importance of identifying timely management for improving better outcomes.