Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Bilateral Technique of Penis Flap with Scrotum Skin in Penile Paraffinoma Cases: A Case Report
Background: Paraffin injection into the penis is one way that people see it as increasing penis size. But many do not know that paraffin injection actually causes side effects in the form of penile paraffinoma. This study aimed to describe the management of paraffinoma using bilateral techniques.
Case presentation: A 40-year-old married man came to the emergency room at Samuel J. Moeda Naval Hospital, Kupang, with complaints of pain and swelling of the penis for 6 hours. The pain felt to get worse when the penis was erected. The genital organs found swelling of the entire penile skin accompanied by tenderness and induration. The bilateral scrotal flap technique was because the scrotal skin had many blood vessels, good flexibility, little adipose tissue, thin skin, and could feel erogenous sensations almost the same as the physiological characteristics of the penile skin.
Conclusion: Bilateral scrotal flap technique on the penile shaft is a surgical technique that is quite effective in eradicating paraffin from penile tissue
The Difference of Survival Rate COVID-19 in Patients with Initiated Hemodialysis and Regularly Hemodialysis
Background: Since December 2019, a novel coronavirus called SARSCoV-2 (severe acute respiratory syndrome coronavirus) has caused an international outbreak of respiratory illness described as COVID-19. This study aimed to describe the difference in the survival rate of COVID-19 induced AKI with hemodialysis and COVID-19 in patients with CKD on hemodialysis in Dr. M Djamil General Hospitals. Also, in this review, we provide a comprehensive overview of data on the factors that may be affected by COVID-19 survival rates in patients with COVID-19 induced AKI with hemodialysis and COVID-19 in patients with CKD on hemodialysis. This study was conducted to analyze the survival of COVID-19 with initiated or regular HD patients in Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: This study was conducted from January 2021 to July 2021 in Dr. M. Djamil General Hospital, Padang, West Sumatera, Indonesia. Data for this study was collected through medical records of patients admitted for COVID-19 with CKD in hemodialysis and acute renal failure induced by COVID-19 to show the demographics, comorbidities, and survival rates of the patients who underwent hemodialysis.
Results: Factors associated with survival in COVID-19 with hemodialysis were COVID-19 severity and abnormal potassium serum level (Table 3). Moderate COVID-19 patients tend to survive than severe COVID-19 patients (OR 60; 95% CI 16.034 – 224.525). There was no significant difference in survival between initiated and regular HD (p = 0.829).
Conclusion: There is no difference in clinical outcome from patients with COVID-19 who initiated hemodialysis or regularly HD to the survival rates
Anesthesia Management in Morbidly Obese Patient Undergoing Neurosurgical Procedure: A Case Report
Background: Anesthesia management in morbidly obese patients undergoing any neurosurgical procedure is particularly challenging. This case report aims to further discuss the importances and concerns regarding the anesthesia management of decompression craniectomy in morbidly obese patients.
Case presentation: A 46-years-old male patient was diagnosed with intracerebral hemorrhage on regio left external capsule due to hypertensive emergency suspected from Middle Cerebral Artery (MCA) aneurysma rupture. Decompression craniectomy with clot evacuation was planned. This patient has morbid obesity. Prediction of difficult intubation and mask ventilation can be assessed using LEMONS, MOANS, Mallampati score and STOP-Bang Questionnaire. The dosage of anesthetic agents used in these patients had been adjusted according to current recommendations. Intraoperatively, patient’s hemodynamic was successfully maintained stable. Postoperatively, patient was closely monitored in the intensive care unit.
Conclusion: It is imperative to acquire adequate knowledge on choosing the effective anesthetic management during the preoperative, intraoperative, and postoperative periods to achieve good outcome in morbidly obese patient undergoing neurosurgical procedures
Management of Extensive Subcutaneous Emphysema with Blow Hole Infraclavicular Incision and Continuous Suction Installation
Background: Subcutaneous emphysema often occurs in cases of implanted pneumothorax chest tubes and must always be evaluated. Subcutaneous emphysema is a condition where air or gas is found in the tissue under the skin.
Case presentation: A 49-year-old man was treated for sudden shortness of breath that occurred after a violent cough accompanied by pain and heaviness in the chest area 1 day before admission to the hospital. The patient had previously received anti-tuberculosis drug treatment for 6 months based on chest X-ray results in 2022, and the patient had undergone a rapid molecular test (TCM) examination, mycobacterium tuberculosis (Mtb), and obtained Mtb results not detected. Lung auscultation obtains sound intensity breath weakness until it disappears in both lung fields. Palpation of the skin revealed widespread crepitus on the face, neck, upper extremities, back, chest, and abdomen. The range of motion areas of the neck, shoulders, and hands are limited due to pain with movement. Evaluation of the chest tube obtained: the chest tube was installed in the anterior axillary line on the right at the level of the 5th intercostal space with number 10 attached to the chest wall and the chest tube well fixed to the chest wall. The end chest tube has been connected to the WSD bottle, and evaluation of the WSD shows that there are undulations and bubbles.
Conclusion: The patient was admitted with spontaneous pneumothorax secondary to tuberculosis and was implanted with a chest tube
Effectiveness of Nigella sativa Addition against TNF-Alpha in Stage III and IV Breast Cancer Undergoing Doxorubicin and Cyclophosphamide Chemotherapy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Background: Breast cancer is a malignancy caused by the continuous uncontrolled growth of the component cells of the ducts or lobules of the breast gland. Globally, breast cancer is the second leading cause of death in women. Nigella sativa contains substances thymoquinone. Thymoquinone can inhibit the progression of cancer through anti-inflammatory, anti-oxidant mechanisms, inhibit proliferation, trigger apoptosis, and prevent angiogenesis. Chronic inflammation in breast cancer is mediated by one of them is TNF-alpha tumors. Elevated levels of TNF-α have a significant association with poor prognosis and progression of breast cancer. This study aims to determine the effectiveness of the additional Nigella sativa in declining TNF-α levels in breast cancer patients at Dr. Mohammad Hoesin General Hospital Palembang.
Methods: This research used a randomized, open clinical trial design, which was carried out at the internal medicine hematology-oncology medical polyclinic and the surgical oncology polyclinic of Dr. Mohammad Hoesin General Hospital Palembang from January 2023 to October 2023. Data processing for data analysis used SPSS version 26 for Windows.
Results: There were 36 research subjects followed during the study period and received Doxorubicin chemotherapy and cyclophosphamide (AC), which were divided into treatment groups of 18 people (chemotherapy with the addition of Nigella sativa @600 mg 2x2 capsule/ day and a control group of 18 people. A TNF-alpha examination was carried out before and after to assess the comparison before and after. From the results, it was found that TNF-alpha levels in the treatment group showed a decrease in TNF-alpha with a p-value <0.001.
Conclusion: The addition of Nigella sativa has the effect of reducing TNF-alpha in breast cancer patients receiving AC chemotherapy at Dr. Mohammad Hoesin General Hospital, Palembang
Pathogenesis and Minimally Invasive Management of Subcutaneous Emphysema: A Narrative Literature Review
Subcutaneous emphysema is the result of air infiltrating the subcutaneous and soft tissues. The prevalence of subcutaneous emphysema varies between 0.43% and 2.34%. Subcutaneous emphysema typically results in mild symptoms, poses no significant risk, and does not necessitate specific medical intervention. Pathologies affecting underlying tissues can exhibit greater severity and pose a risk to life. Subcutaneous emphysema is a challenge in terms of how to handle it. The treatment should initiate a focused endeavor to determine the underlying etiology of subcutaneous air dissection. This literature review focuses on subcutaneous emphysema, specifically exploring its pathogenesis and therapy strategies for people with this condition
Postoperative Craniopharyngioma in a 10-Year-Old Girl Presenting with Central Precocious Puberty, Central Diabetes Insipidus, and Growth Hormone Deficiency
Background: Hypopituitarism is the most common endocrinology complication of postoperative craniopharyngioma. However, we found a 10-year-old girl with a history of postoperative craniopharyngioma presenting with central precocious puberty (CPP), central diabetes insipidus (CDI), and growth hormone deficiency (GHD).
Case presentation: A 5-year-old girl experienced breast growth followed by menstruation six months later. The patient's weight was 19 kg (weight-for-age: P25-P50), height was 109 cm (height-for-age: P10-P25), and good nutritional status (Waterlow 90%). The stage of pubertal development was M2P2. There was a history of craniopharyngioma, and it was resected at the age of 2 years. After surgery, the patient developed CDI and has received desmopressin. No new tumour growth was found from evaluation with periodic MRIs every three years. After CPP was established, with increased serum levels of LH, FSH, and estradiol, GnRH agonist therapy was given at 100 mcg/kg BW every month. During five years of follow-up, the patient experienced clinical and laboratory improvement. However, the growth is only 3-4 cm/year (<P3) with short stature (height-for-age: <P3) and overweight. Low levels of IGF1 and GH were found in the stimulation test results, so the diagnosis of GHD was confirmed. The patient will receive growth hormone therapy and is expected to reach her potential genetic height (148.5 - 165.5 cm).
Conclusion: Even though the craniopharyngioma tumour has been resected and no recurrence has occurred, it is crucial to evaluate the hormones produced by the pituitary thoroughly
The Role of Nutritional Therapy in Inhibiting the Progression of Chronic Kidney Disease: A Narrative Literature Review
The need for proper nutrition and diet is fundamental in every stage of chronic kidney disease. The principle of nutritional therapy is slowing the progression of chronic kidney disease, delaying patients with CKD (chronic kidney disease) from getting kidney replacement therapy. In CKD patients, there is a disturbance of protein homeostasis, disturbance in metabolism protein, acid-base disorders, and hormonal dysfunctions. As the progression of CKD increases, nitrogen-containing products accumulate, causing a decrease in appetite. In CKD patients, intestinal absorption is also impaired because uremia causes microbiota disturbance and damage to the intestinal epithelium. These various things cause nutritional status to become often irregular, and protein energy wasting frequently occurs, thus requiring dietary adjustments in patients with CKD. In conclusion, each individual with CKD has a different nutritional therapy approach depending on the disease conditions and nutritional status of the individual. Appropriate nutritional therapy in CKD patients can reduce disease progression
The Relationship between Sociodemography and the Level of Knowledge, Attitudes, and Behavior of Breast Cancer Patients at the Surgical Oncology Polyclinic at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Background: Breast carcinoma is the most frequently diagnosed carcinoma in the world. A person's behavior in responding to a health problem is influenced by three factors, namely predisposing factors, supporting factors, and needs factors. The predisposing factor explaining social demographics is one of the things that influence individuals to overcome health problems. This study aimed to assess the level of knowledge, attitudes, and behavior toward breast cancer in advanced breast cancer patients who seek treatment at the surgical oncology polyclinic at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
Methods: This study was an analytic observational study of 329 research subjects. The research subjects were patients at the surgical oncology polyclinic at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Observation of knowledge, attitudes, and behavior was carried out using a questionnaire adapted from the breast cancer awareness scale (BCAS-I). Data analysis was performed univariate, bivariate, and multivariate using SPSS software.
Results: Occupation (p-value 0.000 OR 3.664) has a significant relationship with the knowledge of breast cancer patients. Education and occupation have a significant relationship with the attitude of breast cancer patients. Age 35-59 years and working as a housewife have a significant relationship to the behavior of breast cancer patients.
Conclusion: There is a sociodemographic relationship with knowledge, attitudes, and behavior in breast cancer patients at the surgical oncology polyclinic at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Comorbidities of Gestational Diabetes Mellitus and Urinary Tract Infection: A Case Report
Background: Gestational diabetes mellitus (GDM) is defined as a condition of glucose intolerance that is found during pregnancy. In pregnant women, urinary tract infection (UTI) is one of the most common bacterial infections that can be found. The infection can be worsened by diabetes as it was shown that the risk of UTI in pregnant women with diabetes (27.6%) is higher than those without diabetes (3%-10.1%). This study aimed to present a case of gestational diabetes mellitus and urinary tract infection.
Case presentation: A pregnant woman aged 38 years old with a 15-16 weeks gestational age was admitted with gestational diabetes mellitus and urinary tract infection. The patient was treated with an intravenous insulin drip and antibiotic. The patient was discharged after there was a clinical improvement.
Conclusion: There are many risk factors that can contribute to the development of UTI in pregnant women, with one of those being inadequate glycemic control. The treatment of UTI in pregnant women with GDM is generally the same as in those without GDM