Bioscientia Medicina - Journal of Biomedicine and Translational Research
Not a member yet
1245 research outputs found
Sort by
Axillary Plexus Block for Anesthesia Management in Patients with Acute Compartment Syndrome after Primary Percutaneous Coronary Intervention (PCI) Transradial Approach: A Case Report
Get PDFBackground: Acute compartment syndrome is a rare complication of the percutaneous Coronary Intervention (PCI) transradial approach but it is very hand-threatening. Treatment for acute compartment syndrome is emergent fasciotomy of the affected compartments to reduce intracompartmental pressure. Axillary plexus block is an excellent choice of anesthesia technique for elbow, forearm, and hand surgery.
Case presentation: An 80-year-old, 60 kg, 168 cm man was consulted to our department with a painful swelling on his right upper arm and hand that began three hours after a primary PCI procedure. Previously, the patient had a history of hypertension and diabetes mellitus. The supporting examination results were notable for anemia (Hemoglobin 7,5 g/dL), thrombocytopenia (78 x103/uL), elevated hemostasis function (International Normalized Ratio 1.43), and high blood sugar (360 mg/dL) from echocardiography results anteroseptal and lateral hypokinetic. Before we did block, the patient was given ketamine 10 mcg IV and fentanyl 25 mcg IV for sedation. Axillary plexus block, as a type of regional anesthesia under ultrasound guidance, is a reliable substitute for general anesthesia in high-risk patients, and we do it with a dose of 20 ml of solution (50 mg (10 ml) isobaric bupivacaine 0.5% + 200 mg lidocaine 2% diluted with 20 ml normal saline). During the surgery, the patient was hemodynamically stable. After the operation, the patient was readmitted to the intensive cardiac care unit (ICCU).
Conclusion: Axillary plexus block can be an alternative to general anesthesia in patients who will undergo fasciotomy surgery after percutaneous coronary intervention transradial approach with stable hemodynamics during surgery and well-controlled pain after the surgery
Flexi-rigid Pleuroscopy in Diagnostics of Malignancy: A Narrative Literature Review
Get PDFPleuroscopy is a less invasive treatment that allows access to the pleural cavity with the use of both visual and surgical equipment. This technique can be conducted with local anesthesia and mild sedation. Pleuroscopy is a medical procedure used for both diagnosis and treatment in the pleural cavity. Pleuroscopy enables direct observation of the pleural surface, enhancing the safety of procedures such as pleural biopsy, pleural fluid drainage, and pleurodesis. One purpose is to assist in verifying the diagnosis of cancer. This review was aimed to describe the use of flexi-rigid pleuroscopy in malignancy
Papillary Renal Cell Carcinoma Type 1 Accompanied by Hemorrhagic Anemia: A Case Report
Get PDFBackground: Kidney cancer or renal cell carcinoma (RCC) accounts for 5% and 3% of all adult malignancies in men and women, respectively, thus representing the 7th most common cancer in men, and the 10th most common cancer in women. The incidence of kidney cancer in the last two decades has shown an increase, but in recent years the death rate due to kidney cancer has decreased because it is increasing.
Case Presentation: A 27 year old male patient came with complaints of bloody urination. Patients also complain of body weakness. Every time they are active, the weakness decreases if the patient rests. The patient was stated to be suffering from anemia and a left kidney tumor. There was bilateral antebrachial pitting edema. There was bilateral pretibial edema. Cytological examination revealed papillary renal cell carcinoma type 1.
Conclusion: Papillary cell carcinoma type 1 is a kidney tumor that has a good prognosis, especially if found at an early stage. The classic symptoms of type 1 pRCC are anemia, hematuria and kidney swelling
Opioid-Free Anesthesia (OFA) as a Safe Anesthetic Choice for Epilepsy Patient
Get PDFBackground: The opioid-free anesthesia (OFA) approach, although not widely employed in anesthesia, offers distinct benefits for some populations, such as epilepsy patients, due to the propensity of opioids to trigger seizures. Hence, the objective of this study was to conduct an opioid-free anesthesia (OFA) procedure on the left lateral rhinotomy in a patient with concurrent epilepsy.
Case presentation: Our patient is a 59-year-old woman suffering from epilepsy with a left nasal cavity tumor, scheduled for a left midfacial degloving rhinotomy. Given the patient's epilepsy comorbid, we have opted for an opioid-free anesthesia (OFA) procedure. OFA procedures are not yet widely employed in anesthesia; however, they offer advantages for specific patient populations, including epilepsy patients, as opioids have the potential to induce seizures.
Conclusion: The various OFA protocols being conducted worldwide require refinement, and the potential interactions of each component should be explored further
Central Diabetes Insipidus in Langerhans Cell Histiocytosis: A Case Report
Get PDFBackground: Diabetes insipidus (DI) is part of a group of hereditary or acquired polyuria and polydipsia diseases. Diabetes insipidus can be caused by central and nephrogenic disorders. This study aimed to describe the etiologies, clinical symptoms, and management of central diabetes insipidus in Langerhans cell histiocytosis.
Case presentation: A 4 years 4 months old boy came with excessive and frequent micturition since 9 months ago. The patient drinks 4-5 L per day and still feels thirsty. The patient had a history of Langerhans cell histiocytosis (LCH). During laboratory work-up, urine osmolarity decreased, and serum osmolarity and electrolyte were normal. The patient was diagnosed with central diabetes insipidus with Langerhans cell histiocytosis. The treatment given to the patient is desmopressin.
Conclusion: Langerhans cell histiocytosis may affect any organs of the body. The long-term management of diabetes insipidus in Langerhans cell histiocytosis requires measurement to prevent dehydration and, at the same time to prevent water intoxication. The focus of management is based on the education of the patient about the importance of regulating their fluid intake according to the patient’s hydration status
The Effect of UVB Exposure at Collagen Density and Dermal Thickness of Wistar Rats: A Pilot Study
Get PDFBackground: Skin aging has been characterized by decreasing skin regeneration and loss of structure and function. The most significant cause of extrinsic skin aging is exposure to ultraviolet (UV) radiation (80%). UVB radiation causes DNA damage which leads to dermal thickness reduction. This study aimed to compare the features of collagen density and dermal thickness of rats before and after UVB exposure.
Methods: This experimental study was conducted at the experimental animal laboratory of Universitas Setia Budi, Surakarta, from May to June 2022. The male Wistar rats were epilated and given UVB exposure, and a back skin biopsy was performed before and after the total dose of UVB exposure. The UVB exposure dose was 50 mJ/cm2 in the first week, 60 mJ/cm2 in the second week, and 70 mJ/cm2 in the third and fourth weeks. The UVB tool used was the Kernel® UV Phototherapy KN-4003BL UVB lamp.
Results: The collagen densities before vs. after total dose UVB exposure are 61.9% vs. 50.3% for 4x magnification and 63.8% vs. 49.6% for 10x magnification. The dermal thickness also reduced from 1422.07 ± 1165.96 µm before the total dose of UVB exposure to 1049.52 ± 1018.97 µm after the total dose of UVB exposure.
Conclusion: UVB exposure can induce decreased collagen density and dermal thickness in Wistar skin rats, similar to photoaging
A Rare Case of Nail Lichen Planus
Get PDFBackground: Nail lichen planus (NLP) is often associated with the involvement of other mucocutaneous sites. Though isolated nail involvement can be seen in a number of cases, it is seen in up to 10% of cases. Nail lichen planus is a rare case. This is the first case in the last 5 years in the dermatology and venereology department of Dr. M. Djamil Hospital Padang.
Case presentation: A 26 years old woman came to the Dermatology and Venereology Department at Dr. M. Djamil Hospital Padang with all of her fingernails and toenails ridging, thinning, and brittle, and the color became yellow brown-blackish that worsened 6 months ago. This complaint had been suffered for 5 years ago. Dermatological examination showed onychodystrophy, longitudinal ridging and fissuring, yellow-brownish blackish discoloration on all fingernails and toenails, and there were no skin and mucosa lesions. The dermatology life quality index (DLQI) patient was 8. Potassium hydroxide (KOH) examination and fungal culture were negative. Histopathological examination showed hypergranulosis and sawtooth rete ridges. The patient was treated with clobetasol propionate 0,05% ointment with occlusion twice per day and showed improvement.
Conclusion: Nail lichen planus can occur in the absence of skin or mucosal involvement. In this case, there is no skin or mucosal involvement. The diagnosis in this case is based on clinical, dermoscopic, and histopathological examination
The Effect of Intravenous Essential Amino Acid Supplementation on Recovery of Kidney Function in Acute Kidney Injury Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Get PDFBackground: Acute kidney injury (AKI) is a clinical condition characterized by a rapid decline in kidney function that causes homeostatic failure in regulating fluid, electrolyte, and acid-base balance within hours to days. Nutritional supplementation is effective in replacing lost protein and as an energy reserve. This study aimed to determine the effect of intravenous essential amino acid supplementation on the recovery of kidney function in acute kidney injury patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
Methods: This study is an open clinical trial of experimental research. A total of 34 research subjects participated in this study, where the subjects were grouped into treatment (IV amino acid supplementation) and placebo groups. Data analysis was carried out using STATA in univariate and bivariate.
Results: Administration of amino acid supplements can reduce creatinine by 1.36. Meanwhile, the placebo was unable to reduce creatinine levels and even caused an increase in creatinine by 0.26.
Conclusion: Intravenous administration of essential amino acid supplements has an effect on the recovery of kidney function in acute kidney injury patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Relationship between Albumin Levels and the Incidence of Ascites in Patients with Liver Cirrhosis
Get PDFBackground: Patients with cirrhosis often develop hypoalbuminemia. In conditions of hepatic dysfunction, albumin synthesis is decreased due to hepatic dysfunction and abnormal distribution of portal blood flow. Ascites is a major complication and an important sign in the course of cirrhosis and is associated with 50% mortality after two years. 75% of patients' ascites etiology is liver cirrhosis, 10% malignancy, 3% heart failure, 2% tuberculosis, 1% pancreatitis, and others.
Methods: This cross-sectional study was conducted from the medical records of patients with liver cirrhosis who were treated at the internal medicine section of Dr. M Djamil General Hospital, Padang, in 2015-2020. Patients with heart defects, malignancy, tuberculosis, pancreatitis, kidney failure, and incomplete medical record data were excluded from the study. Patients were grouped according to the presence or absence of ascites and albumin levels. Analysis using the chi-square test in 2020.
Results: From 225 cases, 103 cases were analyzed. 77 were men (74.8%), and 26 were women (25.2%). The age of the patient was in the range of 40-60 years. No ascites were found in 30 people (29.1%), and 73 people (70.9%) had ascites. From normal albumin levels, five were without ascites, and four were with ascites. On mild hypoalbumin, 13 had no ascites, and 38 people had ascites. On severe hypoalbumin, 12 people were without ascites and 31 with ascites. A chi-square test was analyzed, and it was found that there was no relationship between the incidence of ascites and albumin levels (p 0.182).
Conclusion: The incidence of ascites is not related to blood albumin levels
Langerhans Cell Histiocytosis in the Oral Cavity
Get PDFBackground: Langerhans cell histiocytosis (LCH) is a rare hematological malignancy. The incidence of this disease is only 1% of soft tissue and lymph node cancer. Clinical manifestations and organ involvement vary widely. Lesions in the oral cavity are rare. LCH occurs more often in children, 10 times more often than in young adults.
Case presentation: A 20-year-old male came with the main complaint of a lump on the roof of the mouth and the right inner cheek. Physical examination of the face and oral cavity found a mass attached to the palate 1x1x1 cm with the same color as the surrounding tissue, flat surface, soft consistency, could be moved, and a mass was found in the left buccal 2x2x2 cm, with the same color as the surrounding tissue, flat surface, cystic consistency, not fixed and can be moved. Hematology laboratory examination was within normal limits, so no examination was carried out for bone marrow puncture (BMP). From the results of a CT scan of the head and neck, a solid mass was found with a hypodense part in it in the right buccal area attached to m. right masseter, and in the left hard palate area, which was suggestive of Langerhans cell histiocytosis. The results of histopathological examination of the lesion which underwent an incisional biopsy showed positive S100 and CD1a, this patient was diagnosed with Langerhans cell histiocytosis LCH. Next, this patient was treated with excision of the mass in the palate and buccal area. The patient was treated in the surgical inpatient department for 2 days, and the postoperative wound was in good condition.
Conclusion: Cases of Langerhans cell histiocytosis (LCH) are very rare cases that have different clinical symptoms depending on the organs involved, so it is important to understand this disease better. In this case, it was unilocal LCH without the involvement of other organs, so only local therapy was carried out in the form of surgical excision and observation was carried out after 3 months after surgery with the results of the wound improving without any new lumps appearing