Bioscientia Medicina - Journal of Biomedicine and Translational Research
Not a member yet
1245 research outputs found
Sort by
Disseminated Tuberculosis in Breastfeeding Mother: A Case Report
Get PDFBackground: Disseminated tuberculosis is defined as the involvement of two or more extrapulmonary organs due to Mycobacterium tuberculosis infection, which spreads hematogenously. Disseminated tuberculosis is a life-threatening condition, especially if diagnosis and treatment are delayed. This study aimed to describe disseminated tuberculosis in a breastfeeding mother.
Case presentation: A 21-year-old woman was admitted to Dr. M. Djamil General Hospital with chief complaints of shortness of breath. The symptoms were accompanied by chronic cough, fever, night sweats, and weight loss. From the physical examination, there was a decrease in left lung breath sounds as high as right intercostal V. On the gene expert results, the PCR was positive for Mycobacterium tuberculosis. Chest X-ray shows a miliary pattern and left pleural effusion. Pleural fluid analysis reveals the presence of exudate. Patients were treated with anti-tuberculosis drugs, namely Isoniazid, rifampicin, pyrazinamide, and ethambutol, with pyridoxine. Anti-tuberculosis drug therapy in the intensive phase is given for 2 months and is continued for 6-9 months for the continuation phase, depending on the patient's clinical condition. Breastfeeding was still continued in this case. The patient's baby is advised to be evaluated for active tuberculosis.
Conclusion: There are no contraindications for giving anti-TB drugs to breastfeeding mothers unless the mother has mammary TB or drug-resistant TB. In children under 5 years who have close contact with active tuberculosis patients and, after being evaluated, do not have active tuberculosis, the child is treated as suspected latent TB infection with Isoniazid for at least 6 months and accompanied by pyridoxine administration
A Rare Case of Giant Congenital Melanocytic Nevi: A Case Report
Get PDFBackground: Giant congenital melanocytic nevi are often characterised as melanocytic lesions present at birth. It is thought that it affects 1 in 20,000 births. The lesion is significant because it may be associated with serious consequences, such as malignant melanoma, and may also result in neurological deficits, such as neurocutaneous melanocytosis. This study aimed to present the case of giant congenital melanocytic nevus as a rare case.
Case presentation: This study reported a 14-year-old female reported with large blackish rough spots on the trunk that were neither itchy or painful since birth. The patient had no previous history of convulsions, headaches, or vomiting. Plaque hyperpigmentation, macula hyperpigmentation, and hypertrichosis were found on the trunk. Dermoscopy show reveals brown-black homogeneity. Histopathology examination reveals brown-pigmented nevus cells distributed diffusely, with some nevus cells surrounding adnexa skin.
Conclusion: Regular examination is essential to monitor the possibility of neurocutaneous melanosis and malignant melanoma development
Bartter Syndrome: A Case Report
Get PDFBackground: Bartter's syndrome refers to a group of genetic disorders that affect the renal tubular system, which is responsible for reabsorbing various substances such as sodium, potassium, and chloride from the urine into the blood. This study aimed to present a clinical case related to Bartter syndrome.
Case presentation: A 52-year-old male patient in the internal medicine department of Dr. M. Djamil General Hospital Padang with the main complaint of weakness in both legs increasing since 1 day ago. On laboratory examination, the patient found potassium 1.7 mmol/L, indicating hypokalemia. Renal function examination showed normal kidney function. Examination of blood gas analysis showed results of metabolic alkalosis. Examination of urine potassium obtained potassium levels of 22 mmol/day, urine osmolarity of 140 mOsm/kgH2O at serum osmolarity of 274 mOsm/kgH2O, with TTKG (transtubular potassium gradient) = 28. The patient was diagnosed with Bartter syndrome. Treatment is carried out by administering KSR tablets 3x600 mg orally while monitoring electrolytes regularly.
Conclusion: This patient has hypokalemia, metabolic alkalosis, normal magnesium and calcium, and hypercalciuria. This patient is diagnosed with Bartter syndrome
Infiltration Between Popliteal Artery and Capsule of the Knee Combined with Adductor Canal Block as Analgesic Adjuvant During and Postoperative in Total Knee Replacement Surgery
Get PDFBackground: Infiltration between the popliteal artery and capsule of the knee (iPACK) is one method that has been proposed in recent years as a potential alternative to peripheral nerve block as analgesia in total knee replacement (TKR) procedures. This study presents anesthetic management using spinal anesthesia combined with iPACK and adductor canal block (ACB) in patients with grade IV osteoarthritis who underwent TKR of the right knee.
Case presentation: A woman, a housewife aged 50 years, was planning to undergo TKR surgery. The patient came with complaints of pain in the right knee 1 year before entering the hospital. The patient was given supplemental oxygen with a nasal cannula at 3 liters per minute. Prior to spinal anesthesia, the patient was given fentanyl 25 mcg iv, ketamine 10 mg iv, and midazolam 1.5 mg IV as premedication. The patient was positioned on the right side, and a 27G Quincke needle was inserted at the level of L3-L4 and given bupivacaine heavy 0.5% 7.5 mg, then lateralized for 15 minutes. After lateralization, the patient was positioned supine and used ultrasound to direct ACB action with a regimen of ropivacaine 0.25% + dexamethasone 5 mg a volume of 20 ml, then iPACK was performed with a regimen of Ropivacaine 0.375% + dexamethasone 5 mg a volume of 20 ml. After surgery, the patient is treated in the recovery room for 1 hour until bromage score is 0. The patient received the PCA Morphine analgesic demand only 1 mg/mL, 1 mg per dose, max 5 mg over 4 hours, lockout interval 6 minutes; Paracetamol 500 mg every 6 hours PO; Ibuprofen 400 mg every 8 hours PO.
Conclusion: TKR patients who were given analgesia using the ACB peripheral nerve block technique combined with iPACK experienced a decrease in pain levels and lower use of postoperative morphine so that patient mobilization was faster and reduced the patient's length of stay
Incidence of Anemia in Pregnant Women with Closer Spacing of Pregnancies and Multiparity: A Case Report
Get PDFBackground: One of the risk factors that can increase the incidence of anemia in pregnant women is the close spacing of pregnancies and multiparity. Closely spaced pregnancies refer to pregnancies that occur within a short time after the previous birth, while multiparity refers to a woman who has given birth to more than one child previously. The combination of these two factors can lead to an increased risk of anemia in pregnant women. This study presents the risk of closely spaced pregnancies and multiparity for the incidence of anemia in pregnant women. Case presentation: Mrs. SM, 27 years old pregnant woman, came with complaints of severe dizziness for the last 2 weeks. In addition, patients also complain of weakness, weakness, no energy, and no appetite. The patient said that she was currently pregnant with her 4th child, aged 27-28 weeks, with active fetal movements. Hemoglobin examination 7 mg/dL. Conclusion: The patient was diagnosed with anemia in pregnant women with risk factors for close pregnancy spacing and multiparity
Critical Care Management of Fracture Dislocation of Cervical Spine: A Case Report
Get PDFBackground: Spinal cord injuries affect nearly 1 million people every year. More than 90% of all cervical injuries require intubation, most cases also require tracheostomy, and nearly 40% are ventilator dependent.
Case presentation: A 27-year-old male patient complained patient came with complaints of weakness in both limbs 13 hours before admission. Initially, the patient was driving a motorbike, and then the patient was involved in an accident with a car. After the incident, the patient also felt a bit short of breath, could not move both his leg and hand, and could not feel defecation or urination. The patient was diagnosed with fracture dislocation of C4-C5. The patient underwent elective decompression stabilization. Patients admitted to ICU, with the majority requiring assisted ventilation. After five days in the ICU, the patient was challenged to be weaned from the ventilator, so the patient performed an early tracheostomy.
Conclusion: Patients with cervical injuries require comprehensive care in the intensive care unit, especially in airway management and respiratory support, in addition to addressing the potentially catastrophic multisystem sequelae of nerve damage
Transfusion-Related Acute Lung Injury (TRALI): A Narrative Literature Review
Get PDFTransfusion-related acute lung injury (TRALI) is defined as the onset of respiratory distress in a patient after receiving a blood component transfusion. So far, TRALI is considered a rare complication in the field of blood transfusion. However, in the last decade, there has been a shift in perspective. Currently, the US Food and Drug Administration recognizes the syndrome as the leading cause of transfusion-related death. This literature review aims to describe TRALI and its prevention strategies. Understanding the pathogenesis of TRALI drives prevention strategies from a blood bank perspective. A major breakthrough in efforts to reduce the incidence of TRALI was excluding female donors from the high plasma volume product, which resulted in an approximately two-thirds reduction in incidence. However, this strategy has not completely eliminated complications of transfusion. In recent years, research has identified patient-associated risk factors for the development of TRALI and empowered clinicians to take an individualized approach to patients requiring transfusion
Effect of Ramadan Fasting on DNA Repair, Immune System, Inflammation and Cognitive Function in Chronic Kidney Disease Patients: A Systematic Literature Review
Get PDFBackground: There have been many studies that say Ramadan fasting has a positive effect on reducing BMI, blood sugar, inflammatory factors, and DNA Repair. However, there are still no guidelines for fasting in patients with chronic kidney disease (CKD) both nationally and internationally. This study aimed to conduct a review to explore the effects of Ramadan fasting against chronic kidney disease, specifically on DNA repair, Immune System, Inflammation, and Cognitive Function in patients with chronic kidney disease.
Methods: This study is a systematic literature review (SLR) with sources obtained from various reputable journal databases such as PubMed, Cochrane Library, EBSCO, and Elsevier using relevant keywords. The selected articles have passed the inclusion and exclusion criteria. A total of 39 articles that discuss fasting were obtained from Ramadan in chronic kidney disease patients on metabolic response and inflammatory markers in the body.
Results: Ramadan fasting has a positive effect on the response to anti-inflammatory, expression of protective genes, markers of kidney and liver function, protective proteome, and oxidative stress.
Conclusion: Ramadan fasting may provide a short-term protective effect against levels of systemic inflammation
Intensive Management of Diffuse Peritonitis Caused by Spontaneously Healed Gastric Perforation: A Case Report
Get PDFBackground: Gastric perforation will cause acute peritonitis. Proper diagnosis and management, especially in ICU, are needed to prevent complications and even death from this event. This study aimed to describe the intensive management of diffuse peritonitis caused by gastric perforation.
Case presentation: A 61 years old male patient presented with pain in the whole abdomen for 6 days before admission. The pain began at the epigastrium and suddenly spread to the whole abdomen. The pain was felt continuously and increased by movement. Routine blood examination revealed anemia, lekousitosis, and radiology examination found homogeneous confluence was found in the abdominal, dilated small intestine, psoas line was not visible, in the left lateral decubitus position, an air-fluid level and free air were found. The patient underwent diagnostic laparoscopic surgery + peritoneal lavage on emergency surgery for 2 hours, obtained a resolution of gastric perforation, and the patient was treated postoperatively in the ICU of Dr. M. Djamil General Hospital.
Conclusion: Cases of spontaneous resolution of gastric perforation are not only in terms of surgical management but in terms of postoperative care. It also plays an important role in the success and good results in cases of gastric perforation
Correlation of Platelet-Derived Growth Factor-BB Levels as a Biomarker of Liver Fibrosis with the Degree of Fibrosis Based on Fibroscan in Chronic Hepatitis B Patients
Get PDFBackground: Liver fibrosis is scar tissue that forms due to excessive accumulation of ECM proteins due to chronic liver injury, mediated by cytokines involving complex cellular interactions, such as platelet-derived growth factor-BB (PDGF-BB). In Indonesia, no research has been conducted to determine the correlation between PDGF-BB levels and the degree of liver fibrosis based on fibroscan. The aim of this study is to assess the correlation between PGDF-BB levels and the degree of liver fibrosis based on fibroscan in chronic hepatitis B.
Methods: A cross-sectional study was conducted on the chronic hepatitis B population at the internal medicine clinic of Dr. Mohammad Hoesin General Hospital Palembang from January to Agustus 2023. The assessment uses fibroscan to determine the degree of liver fibrosis, measured in kilopascals (kPa). PDGF-BB levels measured by ELISA.
Results: From 40 subjects, the majority of chronic hepatitis B patients were women (57,5%). The lowest PDGF-BB level was found in chronic hepatitis B patients with fibroscan F0, and the highest PDGF-BB level in fibroscan F4. Fibroscan results are directly proportional to PDGF-BB level.
Conclusion: PDGF-BB has a strong positive correlation with the degree of fibroscan in chronic hepatitis B patients in Dr. Mohammad Hoesin General Hospital. The higher the range of PDGF-BB levels, the higher the degree of fibroscan in chronic hepatitis B patients