Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Clonidine as an Adjuvant for Caudal Analgesia in Pediatric Patients Undergoing Infraumbilical Surgery: A Case Report
Get PDFBackground: Caudal block is a popular regional anesthetic procedure used in pediatric patients because it is easy and provides a significant analgesic effect, especially infraumbilical surgeries. Clonidine, an alpha 2 agonist, was previously used for antihypertensives but has recently been found to have analgesic properties, which have been demonstrated in several studies. A number of mechanisms have described how clonidine can exert an adjuvant effect on local anesthetic drugs.
Case presentation: A 6-month-old toddler girl with a planned operation posterior sagittal anorectoplasty. The patient underwent a caudal block with a regimen of 0.25% bupivacaine + 8 mcg clonidine in 10 ml of 0.9% NaCl. Postoperative patient care was carried out in the usual ward with the analgesic regimen of paracetamol syrup 80 mg every 6 hours and ibuprofen syrup 80 mg every 8 hours.
Conclusion: Clonidine, as an adjuvant for the caudal block, has greater benefits than its side effects in pediatric patients undergoing surgery, especially in areas infraumbilical
Case Series of Rare Head and Neck Plasmacytoma: Experiences in Indonesia
Get PDFBackground: Solitary plasmacytoma (SP) is a rare case of plasma cell neoplasms, which only represent 5-10% of all plasma cell neoplasms that afflict two or three people per every 100,000 of the general population. This neoplasm is divided into solitary plasmacytoma of the bone (SBP) and solitary extramedullary plasmacytoma (SEP), depending on the location. Due to the rarity, SBP can be misdiagnosed as multiple myeloma (MM) while SEP as plasma cell granuloma, whereas the treatments are very different. This study aimed to present our experiences in diagnosing SP in the head and neck to differentiate them from MM and plasma cell granuloma.
Case presentation: One case of multiple solitary plasmacytomas of the bone (SPB) in the frontal bone and one case of intraoral solitary extramedullary plasmacytoma (SEP) were presented. The SBP showed abnormality in the laboratory and the CT showed a punch-out lesion which is similar to MM. The SEP showed normal laboratory findings, but the histopathology mimicked plasma cell granuloma. Both immunohistochemistry was positive for CD138, and the SEP diagnosis was confirmed by Ki67 and κ-light chain. Complete examination from history taking, physical examination, radiology and laboratory findings, bone marrow morphology, and histopathology including immunohistochemistry examination, are very important to determine the correct diagnosis.
Conclusion: the case was diagnosed as head and neck solitary plasmacytoma
Comparison of Pain Intensity in Canine Removal Using Closed Coil Spring Niti, Open Coil Spring Niti, Elastomeric Chain Short, Elastomeric Chain Long in Edgewise Standard Fixed Orthodontic Treatment
Get PDFBackground: Every canine is pulled during fixed orthodontic treatment, whether using an elastomeric chain short, elastomeric chain long, closed coil spring, or open coil spring, tends to cause pain for the patient. Which of the four components of the active device is the best in terms of the pain effect felt by the patient. Pain is a symptom that underlies most patients’ rejection of proposed treatment plans. The success of treatment cannot be separated from factors of relief of pain in general, and failure to address these factors may leave patients fearful of returning. This study aimed to compare pain intensity during canine extraction using closed coil spring niTi, open coil spring niTi, elastomeric chain short, and elastomeric chain long in fixed orthodontic treatment standard edgewise.
Methods: This study is a longitudinal experimental research. A total of 16 research subjects participated in this study. The data analysis technique for this research is pain intensity analysis based on the time when the canine tooth is retracted using a tool elastomeric chain short, elastomeric chain long, closed coil spring, open coil spring, using the VAS questionnaire on the 1st, 3rd, and 7th days using non-parametric Kruskal Wallis statistical tests to find out whether there are significant differences between 3 different times on 4 different types of equipment.
Results: There is no difference in intensity pain after canine retraction using closed coil spring, open coil spring, elastomeric chain short, or elastomeric chain long devices in standard edgewise fixed treatment based on VAS on the 1st, 3rd, and 7th days. There is no difference in intensity pain after canine retraction using a closed coil spring appliance in standard edgewise fixed treatment based on VAS on the 1st, 3rd, and 7th days. There are differences in the intensity of pain after retraction of the canine tooth using an elastomeric chain short, elastomeric chain long appliance in standard edgewise fixed treatment based on VAS on the 1st and 3rd days.
Conclusion: There are differences in pain intensity during canine extraction using closed coil spring niTi, open coil spring niTi, elastomeric chain short, and elastomeric chain long in fixed orthodontic treatment standard edgewise
Thoracic Ultrasound: A Narrative Literature Review
Get PDFUltrasonography (USG) is useful in diagnosing abnormalities in the thoracic area, such as pleural effusion, pneumothorax, consolidation, atelectasis, pulmonary edema, etc. The advantages of thoracic ultrasound are low cost, non-radiation, non-invasive, easy to carry, short examination time, and a dynamic aspect that can be seen during the examination. Thoracic ultrasound can be used to guide thoracentesis procedures, chest tube placement, and aspiration of lung abscesses. Ultrasound can be substituted as a computed tomography scan (CT-Scan) as a guide for aspiration and biopsy of the lung parenchyma, pleura, and chest wall. Portable and compact ultrasonography provides the opportunity for ultrasound examinations to become a routine part of an examination, like a stethoscope. Ultrasonography also has limitations in patients with subcutaneous emphysema, peripheral edema, and obesity. Ultrasound examination is very dependent on the experience and abilities of the operator
Aspergillosis in Lung Cancer: A Narrative Literature Review
Get PDFAspergillosis is one of the complications of lung cancer and lung cancer treatment. Diagnosis of Aspergillosis in lung cancer, in general, is still a challenge because clinical symptoms and examination results are not typical, and risk factors often go unnoticed. To simplify the diagnosis of Aspergillosis, several criteria have been created based on the patient's condition, clinical and radiological features, and mycological laboratory examination. Doctors' vigilance still needs to be increased, examination facilities are still limited in certain cities, and diagnostic services have not been integrated, so management is not optimal. This literature review aims to increase doctors' knowledge and awareness regarding aspergillosis in lung cancer, which is an important step to improve the appropriate management of this disease
Difficult Airway Management of Reconstructive Surgery for Noma (Cancrum oris): A Rare Neglected Disease
Get PDFBackground: Noma is a rare necrotizing gangrenous stomatitis that occurs due to poor oral hygiene and chronic malnutrition. Noma’s survivors usually had significant facial deformities that needed reconstructive surgery as its definitive treatment. However, this facial deformity can result in a difficult airway that is very challenging for anesthesiologists.
Case presentation: A 22-year-old male patient had a significant deformity on his left face due to Noma. Preoperative evaluation revealed a potentially difficult airway due to deformity of the maxilla and mandible, malocclusion, inadequate mask seal, and incomplete dentition. Nasal fiberoptic intubation was chosen as the management of a difficult airway in this patient. A tracheostomy was prepared as the emergency invasive airway in the event of failed intubation attempts. Intubation attempts were limited to three times, and the nasal fiberoptic intubation in this patient was successful on the third attempt. The patient was stable, and the airway was safely maintained during the surgery.
Conclusion: Detailed and careful perioperative evaluation had vital role assessing potential difficult airway and planning the optimal airway management for patient with facial deformity. Nasal fiberoptic intubation is still the safest choice with high success rate for Noma patient with significant facial deformity
The Art of Diagnosis from Breath Sound: A Literature Review
Get PDFBreath sounds provide relevant information related to lung abnormalities. It is often difficult to differentiate between breath sounds, this is due to the different characteristics of each breath sound. Differentiating the types of breath sounds is crucial in making an accurate diagnosis. Breath sounds are divided into normal breath sounds and abnormal (additional) breath sounds. Normal breath sounds are sounds that originate from the chest wall, such as tracheal, bronchial, bronchovesicular and vesicular breath sounds. Meanwhile, abnormal (additional) breath sounds are breath sounds that indicate an abnormal condition in the respiratory system. Normal and abnormal breath sounds have different characteristics such as intensity, duration, frequency, quality of air flow, air flow pattern, air distribution, body position, location of sound production, changes in pressure and vibration of dense tissue in the lungs
The Relationship between Plasma Glutamate Levels and Sleep Quality in HIV Patients
Get PDFBackground: Disturbance sleep quality is often found in sufferers of human immunodeficiency virus (HIV). Disturbed sleep quality can affect immunity, which ultimately can increase patient morbidity and mortality. Impaired sleep quality in HIV sufferers is related to neurotoxicity due to the HIV virus, which damages sleep architecture. HIV infection can cause an increase in brain extracellular glutamate. Elevated glutamate plays a role in neuronal and glial damage and death. This study aimed to assess the relationship between plasma glutamate levels and sleep quality in HIV sufferers.
Methods: The research uses a cross-sectional design. The samples were HIV sufferers in a polyclinic voluntary counseling test (VCT) internal medicine of Dr. M. Djamil General Hospital Padang, who met the inclusion and exclusion criteria. Samples are selected by consecutive methods. Sleep quality was assessed using a questionnaire called the Pittsburgh sleep quality index (PSQI). Plasma glutamate levels were measured using the ELISA method. Statistical analysis using SPSS with a p-value <0.05 was considered statistically significant.
Results: The research sample consisted of 82 people. The median plasma glutamate level was 16.39 µg/mL. Impaired sleep quality was found in 45 (54.9%) HIV sufferers. There was no significant relationship between plasma glutamate levels (p= 0.506), age (p=0.795), gender (p=0.547), education (p=0.358), occupation (p=0.255), disease duration (p=0.348), stage (p=0.309) and type of ARV therapy (p=0.791) with sleep quality in HIV sufferers. From this research, a significant relationship was found between sleep quality, body mass index (BMI) (p= 0.015), and marital status (p= 0.039).
Conclusion: There is no relationship between plasma glutamate levels and sleep quality in HIV sufferers. There are other factors that influence sleep quality, namely BMI and marital status
Reperfusion Arrhythmia in Acute Myocardial Infarction
Get PDFManagement of reperfusion in acute myocardial infarction is an important component of myocardial cell survival to minimize the area experiencing infarction and improve patient clinical outcomes. However, this reperfusion also contributes to myocardial injury which is preceded by the ischemic process. One of the injuries related to the ischemia-reperfusion process in the myocardium is reperfusion arrhythmia. Reperfusion arrhythmias from several studies can begin to occur in the first minutes after restoration of obstructed coronary flow. The features of reperfusion arrhythmia can include accelerated idioventricular rhythm, ventricular tachycardia, ventricular fibrillation, and other arrhythmias. The mechanism of reperfusion arrhythmia can be excess calcium in the cells, oxidative stress due to an increase reactive oxygen species, energy metabolism disorders, and neutrophil accumulation. Excessive intracellular calcium and other mechanisms cause a delay in the depolarization of previously ischemic cells. This reperfusion arrhythmia requires special attention because it can disrupt hemodynamics and patient outcomes after reperfusion procedures. Knowledge of the mechanisms of reperfusion arrhythmias will guide clinicians to provide better management during and after reperfusion procedures
Comparison of Dimensional Stability of Alginate Impressions by Spraying 0.5% Sodium Hypochlorite Against Kepok Banana Peel Extract (Musa paradisiaca Linn.)
Get PDFBackground: The process of impressions of hard and soft tissues in the oral cavity is a fairly routine activity in dentistry. Alginate is an irreversible elastic impression material that is often used. Alginate can be disinfected using soaking or spraying techniques. This disinfection solution itself has side effects that are quite serious for patient health. This study aimed to find out Comparison of the dimensional stability of alginate impressions by spraying 0.5% sodium hypochlorite against kepok banana peel extract (Musa paradisiaca Linn.).
Methods: This study was experimental research. The research object used was dimension of alginate impressions which were grouped into control and treatment groups. Assessment of the projection value of the antero-posterior (AP) and cross arch (CA) lines was carried out with digital calipers. Data analysis was carried out with the help of SPSS version 25 in univariate and bivariate.
Results: The results of this study showed that the mean value of the AP and CA lines in the kepok banana peel extract treatment group did not show a significant difference with the control treatment (sodium hypochlorite 0.5%), p-value> 0.05.
Conclusion: Spraying kepok banana peel extract with various concentrations did not cause changes in the dimensions of the alginate impressions