Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Risk Factors Affecting Length of Stay in Preterm Infants at Wangaya Regional General Hospital, Indonesia
Get PDFBackground: Advances in neonatology have led to many preterm infants being saved. Prolonged length of stay (LOS) increases the incidence of neonatal complications and even mortality, placing a significant economic burden on families and strain on healthcare systems. This study aims to determine the factors associated with LOS in preterm infants.
Methods: This cross-sectional study involved 60 preterm babies treated at Wangaya Hospital from May 2022 to May 2023. Infants with congenital anomalies, referred from other hospitals and did not receive appropriate treatment were excluded from the study. Data were taken from the electronic medical record after obtaining ethical clearance and then analyzed using descriptive statistics and linear regression in SPSS 25. Statistical significance was considered at 0.05.
Results: As many as 46 out of 60 preterm infants were born at moderate to late preterm gestational age. The majority of 81.7% of infants were born with a body weight of 1500-2499 grams. The median number of LOS was 7.5 days (IQR 15). Multivariate analysis of numerical independent variables obtained an equation log [LOS] = 2.902-0.066*gestational age+ 0.022*duration of parenteral nutrition (R2 = 78.1%). Meanwhile, in the categorical independent variables obtained, an equation log [LOS] = 0.398 + 0.223*very preterm + 0.144* RDS + 0.178*NEC + 0.206*prolonged antibiotics administration + 0.278*late enteral feeding + 0.148*abdominal distension + 0.144*vomiting (R2 = 87.4%).
Conclusion: Factors influencing LOS of preterm infants are gestational age, duration of parenteral nutrition, the presence of RDS, NEC, vomiting, abdominal distension, late enteral feeding, and prolonged use of antibiotics. It is essential to carry out antenatal care for pregnant women to prevent premature birth
The Role of Invasive Hemodynamic Monitoring in Patients with Severe Mitral Regurgitation Undergoing Herniorrhaphy Operation
Get PDFBackground: Mitral regurgitation (MR) indeed presents challenges during noncardiac surgeries, especially as the severity of MR tends to increase with age and poses a higher risk of perioperative complications. Accurate hemodynamic monitoring becomes crucial in these cases to manage potential complications effectively. However, the standard monitoring in MR conditions during operation, such as TEE, is not always available, but there are other options for invasive monitoring, such as arterial lines, which provide accurate hemodynamic monitoring.
Case presentation: A 64-year-old, male, presented with Reponible Lateral Inguinal Hernia with comorbid of severe mitral and tricuspid regurgitation alongside congestive heart failure. The patient was premedicated with fentanyl 25 mcg intravenously, followed by oxygen supplementation with 3 lpm nasal cannula and insertion of the arterial line. Anaesthesia was performed using a lumbar epidural technique, with the insertion of an epidural catheter in the L1-L2 intervertebral space, Reponible Lateral Inguinal Hernia. The local anesthesia agent chosen was plain bupivacaine with a concentration of 0.5% and a volume of 8 ml. The onset of action of epidural anesthesia is achieved within 20 minutes as long as the operation reaches a total blockade as high as T8. The patient is monitored with standard monitors and an artery line during surgery. There were no complaints of shortness of breath, chest heaviness, or chest pain felt by the patient during the operation.
Conclusion: Epidural anesthesia technique can provide stable hemodynamics in patients with severe mitral-tricuspid regurgitation and congestive heart failure and hemodynamic monitoring plays an important role postoperatively to prevent further deterioration and maintain stability
Strangulated Incisional Hernia Post Appendectomy: A Rare Case Report
Get PDFBackground: Incisional hernia is a condition in which internal organs, such as the intestines, protrude through a previous surgical incision or suture. This occurs due to the failure of the abdominal wall to close properly. The closure of the abdominal wall is influenced by patient-related factors and technical factors during surgery. Incisional hernia following appendectomy is a rare condition, with an incidence rate of less than 0.12%. With this case report, the author aims to contribute to the literature on strangulated incisional hernia post-appendectomy.
Case presentation: A 42-year-old male presented to the emergency department with complaints of right lower abdominal pain for the past three days. The patient reported a lump that had been intermittently present for the past nine years but became persistent three days ago. The patient had a history of appendectomy nine years ago. Vital signs were relatively stable, and physical examination revealed a bluish mass measuring 10x8x4 cm in the abdomen. Radiological abdominal assessment revealed a high-level obstructive ileus. Subsequently, the patient underwent a laparotomy, and a right hemicolectomy was performed, removing a segment measuring 50 cm from the ileocecal junction to the ascending colon.
Conclusion: Incisional hernia following appendectomy is a rare complication, but it can occur due to various risk factors, such as surgical site infection, improper choice of suture material, and inappropriate wound closure technique. The management of this condition can involve the use of tension-free synthetic mesh in either laparotomy or laparoscopy
Differences in Facial Skin Acidity Levels of Nurses in Sebelas Maret University Hospital, Before and After Surgical Mask Use During the COVID-19 Pandemic
Get PDFBackground: Indonesia has reported more than 4 million confirmed COVID-19 cases as of November 2021. This has led to an increase in the use of personal protective equipment (PPE), for example, surgical masks in hospitals, especially referral hospitals for COVID-19 patients. The Potential Hydrogen (pH) or level of acidity plays an important role in the body's physiological functions and regulates the formation of an epidermal barrier (stratum corneum). Thus, the use of surgical masks is able to influence the pH of human skin. This study aimed to determine the difference in facial skin acidity (pH) levels of nurses at Sebelas Maret University Hospital before and after surgical mask use.
Methods: The study utilized a cross-sectional observational method and was conducted at the Sebelas Maret University Hospital, Surakarta. A total of 55 subjects were involved in this study, and each subject’s facial skin Potential Hydrogen (pH) was measured before and after surgical mask use. Subsequently, all data were analyzed with a T-test using SPSS 21.00, and a p-value <0.05 indicated statistical significance.
Results: The results showed facial skin pH increased after surgical mask use for nurses at the Sebelas Maret University Hospital (p = 0.000).
Conclusion: An increase in the physiological value of skin pH was observed in the nurses of Sebelas Maret University Hospital after surgical mask use.
 
The Relationship between Metabolic Control Status and Microalbuminuria in Pediatric Diabetes Mellitus Patients at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Diabetes mellitus (DM) is a complex metabolic disorder that can cause many complications. HbA1c measurement can help monitor long-term serum glucose regulation. Microalbuminuria in DM patients is a risk factor for these complications, so evaluation of risk factors for prevention is necessary. This study aimed to determine the relationship between metabolic control status and microalbuminuria in pediatric diabetes mellitus patients at Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: This study is an analytic observational study with a cross-sectional approach. A total of 34 children with DM aged 1-18 years participated in this study. Sampling was carried out using the consecutive sampling method at the pediatric polyclinic of Dr. M. Djamil General Hospital, Padang, Indonesia, from November 2021-April 2022. Metabolic control status was assessed by measuring HbA1C levels and microalbuminuria by measuring the urine albumin-creatinine ratio. Data analysis used the Chi-square test, with a p-value <0.05.
Results: The average respondent was 13.2 ± 3.3 years old with a duration of suffering from DM 2.5 ± 2 years. Most of the respondents were male (52.9%), suffered from type 1 DM (94.1%), had uncontrolled metabolic control status (82.3%), had a normal creatine albumin ratio (82.4%), never had diabetic ketoacidosis (79.4%), had no family history of DM (85.3%) and had normal blood pressure (94.1%). It is known that the average urea and creatinine are within normal limits. The average HbA1c value is 11.9 ± 3.39%. The median urine creatine albumin ratio was 7.98 (0-255.74) ug/mg. Microalbuminuria in uncontrolled metabolic control status was found in as much as 17.6%, whereas in controlled metabolic control status, no microalbuminuria was found. Statistically, there is no significant relationship (p>0.05).
Conclusion: There is no relationship between metabolic control status and microalbuminuria in pediatric diabetes mellitus patients at Dr. M. Djamil General Hospital, Padang, Indonesia
The Relationship between Neutrophil Lymphocyte Ratio and Hepatitis C Virus RNA in Hepatitis C Coinfected HIV Patients Receiving Direct-Acting Antiviral Therapy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Get PDFBackground: Hepatitis C is an inflammatory disease of the liver caused by infection with the hepatitis C virus (HCV). Inflammatory markers are significant in assessing the course of an infectious or inflammatory disease. One of them is the neutrophil-lymphocyte ratio (NLR) and the amount of HCV RNA viral load, which combines neutrophils as an active inflammatory component and lymphocytes as a regulatory and protective component in a single parameter. Research on the relationship between NLR and HCV RNA in HIV patients coinfected with HCV is still limited. This study aimed to determine the relationship between NLR and HCV RNA in HIV-HCV coinfected patients who received DAA therapy and went to the outpatient polyclinic at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
Methods: Analytic observational study. A total of 38 research subjects participated in this study. Observation of NLR was carried out using hematology analyzer, and observation of HCV RNA levels was carried out using the PCR technique. Data analysis was carried out using SPSS univariate and bivariate.
Results: There was a difference between pre-post therapy NLR and pre-post therapy HCV RNA viral load, p<0.05. NLR is in line with HCV RNA viral load as a prognostic tool for successful DAA therapy in HIV patients coinfected with hepatitis C.
Conclusion: There is a relationship between HIV and HCV RNA in hepatitis C coinfected HIV patients receiving direct-acting antiviral therapy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
The Role of Immunophenotyping in the Diagnosis of Acute Leukemia: A Narrative Literature Review
Get PDFLeukemia is the expansion of leukocyte cells in the bone marrow, which results in an increase in the number of leukocyte cells in the blood circulation and abnormal cell proliferation in the lymphatic tissue. The diagnosis of leukemia is established based on anamnesis, physical examination, and laboratory and confirmed by supporting examinations such as bone marrow aspiration to immunophenotyping. This literature review aimed to describe the role of immunophenotyping in the diagnosis of acute leukemia. The working process of immunophenotyping consists of a group of cells stained with a fluorochrome-conjugated antibody as a dye that is targeted to antigens on the cell surface. Most of these antigens are assigned a cluster of differentiation (CD) numbers. In conclusion, immunophenotyping analysis using multiparameter flow cytometry is an essential tool in detecting leukemia. Immunophenotyping examination is very useful for determining the diagnosis of leukemia. Targeted therapy is one of the modalities of leukemia therapy that is selective for certain cells that can be given based on the results of immunophenotyping
The Relationship of Gastrointestinal Disorders to Malnutrition in Children with Cerebral Palsy in the WKCP Community (Wahana Keluarga Cerebral Palsy) Yogyakarta, Indonesia
Get PDFBackground: One of the causes of malnutrition that often occurs is gastrointestinal disorders. The existence of anatomical and physiological abnormalities in the gastrointestinal tract is the main cause. This study aimed to assess the relationship between gastrointestinal disorders and the incidence of malnutrition in children with cerebral palsy in the WKCP community Yogyakarta, Indonesia.
Methods: A cross-sectional analytic observational study involving 20 cerebral palsy subjects who met the inclusion and exclusion criteria. The data collection technique is by consecutive sampling. The type of data used in the research uses a questionnaire gastrointestinal symptoms rating scale (GSRS). Data status anthropometry has also been collected. Data analysis using SPSS with chi-square.
Results: The mean age of the subjects was 8.9 ± 4.1 years. The male gender (60%) is greater than the female. The comparison of good nutritional status and malnutrition is not much different, namely 55%:45%, respectively. The percentage of children experiencing severe gastrointestinal symptoms is 25%. The most common gastrointestinal disorders are constipation (65%) and upper dysmotility disorders (60%). In the results of this study, there was no relationship between gastrointestinal disorders and the incidence of malnutrition (p=0.069).
Conclusion: In this study, there was no significant relationship between gastrointestinal disorders and malnutrition in children with cerebral palsy. However, gastrointestinal disorders increase the morbidity and mortality of children with cerebral palsy, so it must be an important concern
The Effect of Topical Glutathione on Malondialdehyde Levels in Rat with Cataract-Induced Sodium Selenite
Get PDFBackground: Oxidative damage plays a key role in the lens opacity process. Reducing glutathione (GSH) is a tripeptide protein capable of preventing the accumulation of dangerous levels of oxidation products such as hydrogen peroxide and protein disulfide bonds. Human cataract lenses contain reduced levels of reduced glutathione, so by maintaining high levels of reduced glutathione in vivo, it may be possible to prevent opacification of the lens. This study aimed to determine the effect of topical glutathione on sodium selenite-induced cataracts based on the MDA level of the rat lens.
Methods: This was an experimental study using 30 rats grouped into 3 groups (K+, P1, and P2). At the end of the study, the lens was dripped with Mydriaticum, then assessed for lens opacity. The more opacity lens was extracted, and subsequently, malondialdehyde level was measured. MDA level was analyzed using the One Way ANOVA test.
Results: The average values of rat MDA Lens levels in the K+, P1, and P2 groups were 1.91, 1.38, and 1.2 nmol/mL. Statistically, there was a significant difference in MDA levels in each treatment group with p = 0.001 (p <0.05). Analysis of the average difference in MDA between each group showed that the average MDA level of rats in the P2 group was lower than P1, the MDA levels in the P1 and P2 groups were lower than K+, and there were statistically and clinically significant differences.
Conclusion: Topical glutathione can effectively reduce the progression of cataracts in the lens of rats induced by sodium selenite which is identical to senile cataracts in humans in its mechanism of oxidative stress
Intensive Management of Postoperative Septic Shock in Patient with Secundum Atrial Septal Defect: A Case Report
Get PDFBackground: Sepsis is a life-threatening organ dysfunction caused by an abnormal inflammatory response to infection. This study aimed to describe the intensive management of postoperative septic shock in secundum atrial septal defect patients.
Case presentation: A 28-year-old woman complaining of pus discharge and reddish swelling in the scar after a cesarean section operation. The patient has a history of pulmonary hypertension and secundum ASD. While in the ICU, examination of vital signs found the patient was weak, compost mentis conscious, blood pressure 80/55 mmHG (MAP 63), Respiration 28 times per minute, pulse 114 times per minute, temperature 38.6°C with 98% oxygen saturation with NRM 10 L/ and laboratory examinations obtained hemoglobin 8.6, leukocytes 14.870, platelets 236.000, hematocrit 24, albumin 2.4 and procalcitonin > 100.
Conclusion: This study reported that septic shock is a life-threatening condition, especially in patients with congenital heart disease. Appropriate, rapid, and comprehensive treatment and addressing the source of infection are essential in managing sepsis shock