Bioscientia Medicina - Journal of Biomedicine and Translational Research
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One-Way Valve as Management of Chest Tube Ambulation in Pneumothorax Cases
Get PDFAn adequate chest drainage system is the main goal of fluid and air evacuation and restoring negative pressure intrapleural so it can help lung development. The intrapleural is a closed, airtight space filled with a small amount of fluid as a lubricant for lung movement during the breathing process. Accumulation of intrapleural air is known as pneumothorax, and one of the initial management options is the implantation chest tube. Chest tubes, which are connected to a water seal, conventionally show varying results and have shortcomings because they require monitoring and limit patient mobility, so the safety of their use in outpatient settings is questionable. Lungs that are not inflated or have an inflated water seal still show air bubbles even though it has been installed. A chest tube adequate for 48 hours is a condition known as persistent air leak, thus requiring extended usage time from chest tube to the drainage management complex. Use of ambulation management through the use of various tools and equipment devices which can be connected with a chest tube can be an option with the aim of reducing treatment time, lowering funding, increasing comfort and hopefully providing better external results
The Relationship between Dickkopf-Related Protein-1 (DKK-1) Plasma Levels and Impaired Cognitive Function in HIV Patients
Get PDFBackground: Dickkopf-related protein – 1 (DKK-1) is an antagonist protein to the Wingless (Wnt)-β catenin signal. Dysregulation of Wnt-β catenin signaling by DKK-1 causes disruption of neuronal synapses, which can result in impaired cognitive function. Impaired cognitive function in people with HIV or HIV-associated neurocognitive disorder (HAND) is a spectrum of cognitive disorders related to HIV neuroinvasion and neuroinflammation, which significantly results in impaired cognitive function and daily activity. This study aimed to assess the relationship between plasma DKK-1 levels and impaired cognitive function in HIV patients.
Methods: This study used a cross-sectional design, consisting of 84 HIV sufferers who went to the voluntary counseling and testing (VCT) polyclinic at Dr. M. Djamil General Hospital, Padang, Indonesia, in the period December 2022 - March 2023, who met the inclusion and exclusion criteria. Cognitive function was assessed using the Montreal Cognitive Assessment Indonesian version (MoCa-Ina), and daily activity function using the instrumental activity of daily living (IADL) examination. Plasma DKK-1 levels were measured using the enzyme-linked immunosorbent assay (ELISA) method.
Results: The mean plasma DKK-1 level of HIV sufferers was 358.4 (+ 157.6) pg/mL. ANI type disorder was found in 78.6%, MND in 21.4%, and no HAD type. There was a significant relationship between plasma DKK-1 levels and impaired cognitive function in HIV patients (OR = 2.82, CI95% = 1.128-7.043, p = 0.025), but there was no significant difference in plasma DKK-1 levels between types of cognitive impairment ANI and MND (p = 0.858).
Conclusion: Plasma DKK-1 levels are significantly associated with impaired cognitive function in HIV patients
The Effects of Vitamin E Administration in Non-Alcoholic Fatty Liver Disease
Get PDFNon-alcoholic fatty liver disease (NAFLD) is a liver disease which has high prevalence in the society. There is no drug that is considered to be able to effectively treat this disease until today. The treatments has wide range from modifications to diet and exercise. The role of vitamin E in the treatment of NAFLD has been studied in many researches. It has high antioxidant capacity that have the ability to decrease the level of reactive oxygen species (ROS) and prevent oxidative damage that can cause cellular senescence and apoptosis. The antioxidant properties may inhibit the progression into liver damage and may even treat hepatic fibrosis in NAFLD. It also has an anti-inflammatory role that affects various inflammatory cytokines produced in NAFLD. The use of vitamin E in non-alcoholic steatohepatitis without diabetes is advised by recent guidelines from the American Association for Study of Liver Disease (AASLD) and the European Association for the Study of Liver Disease (EASLD). In patients with non-alcoholic steatohepatitis, vitamin E can decrease oxidative stress, inhibit the pathogenesis of the disease, and be used as a therapeutic option. However, new research on the safety and efficacy of vitamin E in treating diabetic non-alcoholic steatohepatitis patients is still deemed insufficient
A 63-Year-Old Man with Neurofibromatosis Type 1 and Intracerebral Astrocytoma: A Case Report
Get PDFBackground: Neurofibromatosis type 1 (NF-1) is one of the hereditary neurocutaneous disorders. Neurofibromatosis type 1 has broad clinical manifestations that can occur in the skin, bones, eyes, and nervous system. In progressive cases, NF-1 can malign and cause intracerebral tumor lesions. Astrocytoma, especially pilocytic astrocytoma, is one of the tumor classes that patients with NF-1 can develop with far-reaching disease progression. This case report presents a case of NF-1 with intracerebral astrocytoma.
Case presentation: A 63-year-old man with whole body lumps since childhood presented with weakness in the right limbs 1 month ago. 3 months earlier, the patient also had a full-body seizure for 1 minute twice. The patient then underwent a magnetic resonance imaging (MRI) examination of the brain and found a mass in the left centrum semiovale, left corona radiata, left insular, left external capsule, and left frontotemporoparietal lobe with a size of 7.2 x 5.3 x 6.2 cm. The patient then underwent a VP shunt followed by tumor resection. The tumor was successfully evacuated, and histopathological examination with hematoxylin & eosin (HE) staining revealed glioblastoma multiformis. The patient also underwent histopathologic examination with Ki-67 immunohistochemistry (IHC) staining and showed pilocytic astrocytoma.
Conclusion: Craniotomy of tumor excision is the definitive therapy in neurofibromatosis patients accompanied by intracerebral astrocytoma
Bronchoalveolar Lavage in Interstitial Lung Disease: A Narrative Literature Review
Get PDFEstablishing a diagnosis of interstitial lung disease (ILD) is very important because the diagnosis of ILD is often missed with other lung diseases. Apart from clinical diagnosis of ILD, other tests are also required, such as a lung biopsy, which can be done using open lung biopsy but has high mortality and morbidity rates. Apart from that, lung biopsy can be done using video-assisted thoracoscopy (VATS) and transbronchial biopsy, but it is relatively more expensive compared to examination bronchoalveolar lavage (BAL), which is another diagnostic approach of ILD. Bronchoalveolar lavage is performed using a flexible fiber bronchoscope (fiberoptic bronchoscopy), which has a lower morbidity and mortality rate
Peripartum Cardiomyopathy: A Case Report
Get PDFBackground: Peripartum cardiomyopathy (PPCM) is a type of dilated cardiomyopathy of unknown origin. Predisposing factors for PPCM are multiparity, family history, ethnicity, smoking, diabetes, hypertension, preeclampsia, malnutrition, and advanced age in pregnant women or teenage pregnancy.
Case presentation: A 29-year-old female patient was treated in the internal medicine department of Dr. M. Djamil General Hospital Padang on March 18th, 2023, with the main complaint of shortness of breath. On physical examination, signs of congestion were found. ECG shows sinus tachycardia, QT prolongation, and T inversion in V3-V6, II, III, and aVF. The patient is established with peripartum cardiomyopathy, community-acquired pneumonia, nonsevere low-risk MDR, hypochromic microcytic mild anemia et causa chronic disease, high-risk VTE, h hypokalemia et causa diuretic.
Conclusion: Education regarding recurrent recurrence of PPCM in subsequent pregnancies is 30-50%. The prognosis depends on the recovery of left ventricular function; 30% of patients can return to baseline ventricular function within 6 months, and 50% of patients have an improvement in symptoms and ventricular function. Contraception is recommended that does not pose a risk of thromboembolism, such as a uterine device (IUD) and subcutaneous progesterone
Allergy on HIV Infections: A Narrative Literature Review
Get PDFHIV infection causes not only immune insufficiency but also immune dysregulation. Following HIV infection, cytokine profiles change, with a production of IL-4 rising along with IL-5 and a decrease in INF-g. This literature review aimed to describe allergy on HIV infection. At the initial phase after infection, cytokines produced by Th1 and Th2 are balanced, but later as the infection progresses, cytokines produced by Th2 will rise, while cytokines produced by Th1 will fall. Elevation of IL-4 will make B cells produce more IgE. Patients with even lower CD4 still have this allergic phenomenon caused by IgE. Allergic manifestations of HIV include rhinitis, asthma, adverse cutaneous drug reactions (ACDR), immune reconstitution inflammatory syndrome, hyperallergic state (IRIS), and atopic dermatitis. In conclusion, it is important to consider allergic manifestations even in AIDS patients, especially incidents of ACDR and IRIS, which can be life-threatening
The Effects of Pancreatic Omentoplasty on Weight Loss, Improvement of Triglyceride and Interleukin-1 Levels in Obese Rats with Type II Diabetes Mellitus Performed Sleeve Gastrectomy
Get PDFBackground: Obesity can trigger inflammation or inflammatory disease, which is one of the main features of adipose tissue dysfunction. Adipose secretes several different peptides called adipocytokines, which can induce several pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1. Omentoplasty pancreas dan sleeve gastrectomy is a surgical technique that can treat overweight and metabolic syndrome in obesity and type II DM. This study aims to determine the effect of pancreatic omentoplasty on weight loss and improvement of triglyceride and interleukin-1 levels in rats obesity with type II diabetes mellitus performed sleeve gastrectomy.
Methods: This study is an experimental study in vivo. Eighteen rats participated in this study and were grouped into the control group (KI) and the KII and KIII treatment groups. Triglyceride levels were assessed using the spectrophotometric method, and IL-1 levels were assessed using the ELISA method. Data analysis was carried out using SPSS univariate and bivariate.
Results: The KII and KIII treatment groups experienced a decrease in body weight, triglyceride levels, and Interleukin-1 levels of rats after the treatment intervention, p<0.05. The KIII treatment group showed the most significant reduction in body weight, triglyceride levels, and Interleukin-1 levels compared to the KII treatment.
Conclusion: Pancreatic omentoplasty is effective in reducing body weight, reducing triglyceride levels, and reducing IL-1 levels in obese rats with type II diabetes mellitus undergoing sleeve gastrectomy surgery
LENT Score as a Prognosis Factor for Overall Survival and Progression-Free Survival in Malignant Pleural Effusion Patients at Tertiary Hospitals in West Sumatera, Indonesia
Get PDFBackground: Malignant pleural effusion (MPE) has a variable survival rate and prognosis. The LENT score is one method for assessing survival rates in patients with MPE. This study aimed to investigate the LENT score as a prognostic factor for overall survival (OS) and progression-free survival (PFS) of patients with MPE at a tertiary hospital in West Sumatera.
Methods: This study was an observational analytic study involving several tertiary hospitals in West Sumatera with a minimum observation period of 2 years. Data were collected from medical records. We used Kaplan Meier analysis to assess OS and PFS.
Results: A total of 198 subjects met the inclusion criteria. Most MPE patients in this study were aged ≥60 years, male, smokers, pleural fluid lactate dehydrogenase value <1500, ECOG 1, serum NLR value <9, and high-risk cancer, namely lung cancer. The distribution of LENT scores for MPE patients was evenly distributed among the low, medium, and high-risk groups. Kaplan Meier analysis showed that the median OS based on LENT scores were 804 days, 275 days, and 161 days, respectively (log-rank test p = 0.000). The median PFS based on LENT scores were 715 days, 202 days, and 106 days, respectively (log-rank test p=0.000). The OS and PFS findings are longer than previous studies.
Conclusion: Based on LENT scores, overall survival and progression-free survival MPE patients at tertiary hospitals in West Sumatera have a better prognosis compared to previous studies
Intensive Management of A 21-Year-Old Male Patient with Acute Respiratory Failure Due to Near Drowning: A Case Report
Get PDFBackground: The mechanism of near drowning involves decreased lung compliance and aspiration of water into the lungs, which damages surfactants and disrupts alveolar capillary membranes. This leads to the development of alveolar oedema, and ventilation-perfusion mismatch, which causes hypoxemia leading to acute respiratory distress syndrome (ARDS) and cause other organ dysfunction and death.
Case presentation: The patient was found drowned by his friends while on vacation and swimming in the river. Initial physical examination in the ED obtained a Glasglow coma scale (GCS) score of 14/15 (E3-V5-M6), blood pressure 124/70 mmHg, and pulse 124 beats/min. The patient breathed spontaneously 25 breaths/min with oxygen saturation (SpO2) of 90% on room air. The patient was initially managed with oxygenation using a non-rebreathing mask (NRM semi-fowler positioning and peripheral access. Chest X-ray and other radiologic examinations, including a brain CT scan, were performed before the patient was immediately transferred to the ICU, and there was no evidence of other trauma. During the 9 days of intensive management in the ICU, there was a good improvement from GCS 14 to 15.
Conclusion: Intensive management of a 21-year-old male patient with acute respiratory failure due to near drowning