Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Validation of the Dash, Bhondave, and Gadekar Score System to Predict the Difficulties of Laparoscopic Cholecystectomy
Get PDFBackground: One of the treatment options for cholelithiasis is laparoscopic cholelithiasis. The challenge of this procedure is to determine the level of surgery.
Methods: This analytic cross-sectional study was conducted at Sanglah Hospital Denpasar from January 2019 to September 2020. Several risk factors data were assessed according to the Risk Scoring System for Laparoscopic Cholecystectomy. Receiver Operating Characteristic (ROC) curve was plotted to determine the cut-off score based on the most optimal sensitivity and specificity to predict the difficulty of surgery. Univariate statistical analysis was conducted based on the type of data with a p-value <0.05 considered significant.
Results: From a total of 62 laparoscopic cholecystectomies, 36 (58.1%) case was a simple surgery, and 26 (41.9%) was difficult surgery. In the difficult surgical group, 17 surgeries (27.4%) were more than 60 minutes, nine surgeries (14.5%) with bile spillage, and one surgery (1.6%) with ductal injury. The scoring system had a sensitivity of 86.1%, a specificity of 76.9%, a positive predictive value of 83.7%, and a negative predictive value of 80%.
Conclusion: A scoring system is a promising approach to estimating the difficulty of laparoscopic cholecystectomy. Further study to improve this scoring system is necessary
Application of Topical Autologous Platelet-Rich Plasma for Treatment of Pemphigus Foliaceus Wounds: A Case Report
Get PDFBackground: Pemphigus foliaceus (PF) includes lesions on the skin, generally without involving the mucosa. Wounds in PF arise on the outer layer of the superficial skin, but if left untreated, the wound will not heal and will multiply. Platelet-rich plasma (PRP) containing a variety of different growth factors can be used in wound care. This study was at a time to describe autologous PRP therapy in the treatment of excoriated erosional wounds in patients with pemphigus foliaceus.
Case presentation: A woman, 35 years old, married, a housewife living in suburban, comes to the emergency department with complaints of blisters accompanied by pain in the face, body, and back which has been increasing since 1 month ago. Examination of the skin showed palpebral blisters on the eyelids of the left and right eyes. In the anterior and posterior trunk regions, proximal 1/3rd and suprapubic extremities, there are hyperpigmented erythematous macules, multiple, nummular-plaque, discrete, partially confluent, with white to brownish scales, single layer and exfoliative. In the posterior trunk region, Nikolsky's sign was positive. Laboratory evaluation showed an increase in leukocytes and neutrophils. ANA examination showed negative results and anti-ds-DNA 54.91. Management of pemphigus in the form of topical and systemic treatment. Topical management in the form of an open compress with 0.9% NaCl solution, Intrasite gel®, and closed Cutimed sorbact® for erosion and excoriation. Topical PRP was administered on the 7th day of treatment. On the 14th day after treatment with topical PRP, the patient is allowed to go home with the repair of lesions throughout the region.
Conclusion: PRP therapy in cases of pemphigus foliaceus is very useful in improving the clinical condition of the patient
Anaesthetic Management for Caesarian Section Complicated with Eisenmenger Syndrome Concomitant Severe Preeclampsia: A Case Report
Get PDFBackground: Although conception is discouraged in women with Eisenmenger syndrome, in inevitable circumstances, careful and meticulous planning of anesthesia can help the parturient survive the ordeal of a cesarean section. Anaesthetic management is aimed at avoiding haemodynamic changes that increase right-to-left shunt, thereby worsening hypoxemia. This study aimed to present a case of a pregnant woman with Eisenmenger syndrome who underwent caesarean section under general anesthesia management with severe preeclampsia.
Case presentation: A 42-year-old pregnant woman (gravida 3, para 1, abortion 1) was admitted to our hospital at 38 weeks gestation with the chief complaint of shortness of breath and severe preeclampsia. Physical examination revealed cyanotic with clubbing fingers and elevated jugular venous pressure. Laboratory investigations did not reveal any abnormalities. Electrocardiography (ECG) shows normal sinus rhythm and right atrial deviation. General anesthesia was chosen due to obstetric complications, namely severe preeclampsia. The patient was premedicated with a gastroprotective agent, ranitidine 150 mg. At follow-up anesthesia 36 hours after surgery, the patient scored for maximum perioperative comfort and satisfaction.
Conclusion: A multidisciplinary approach is needed to secure maternal and fetal survival for patients with Eisenmenger syndrome. Termination of Caesarean section under general anaesthesia may be the method of delivery that can be used, but care must be taken to avoid excessive and rapid blockade, dehydration, and hypoxaemia
Anxiety Related to Insomnia Severity Level in Medical Pre-clinic Students of the Faculty of Medicine, Public Health, and Nursing Science (FK-KMK), Universitas Gadjah Mada
Get PDFBackground: Anxiety can cause insomnia or sleep disturbances. Sleep disorders are characterized by abnormal sleep patterns that interfere with daily activities. This study aims to describe the relationship between the incidence rate and the severity of insomnia in medical students in the preclinical phase of the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada.
Methods: This research is an observational study with a cross-sectional design. This research was conducted online and carried out from October 2020 to June 2021. Data collection was carried out for 2 weeks using Jotform as a data retrieval medium. The questionnaire used is generalized anxiety disorder-7 (GAD-7) to measure the level of anxiety and insomnia severity index to evaluate the severity of insomnia. Spearman's Rank analysis test was conducted to determine the correlation between anxiety levels and the severity of insomnia.
Results: A total of 130 respondents participated in this study. The majority of respondents are women (71.53%) and are more than 20 years old. Based on Spearman's rank analysis, there was a relationship between anxiety level and insomnia severity (ρ = 0.394), and it was statistically significant with a p-value = 0.000 (p<0.05).
Conclusion: There is a relationship between the level of anxiety and the severity of insomnia in medical students in the preclinical phase of FK-KMK Universitas Gadjah Mada
Relationship between the Number of CD4+ and CD8+ Cells in Patients with COVID-19 (Coronavirus Disease 2019) at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Get PDFBackground: The pathogenesis of COVID-19 involves complex immunological processes that can predispose to disease severity. In COVID-19 patients, there will be changes in the number of CD4 + and CD8 + cells which are part of lymphocyte cells in the specific immune system. This study aims to see the relationship between CD4+ and CD8+ cell counts in COVID- 19 patients at Dr. Mohammad Hoesin Hospital Palembang, Indonesia.
Methods: This research is an observational study with a case series approach. A total of 30 study subjects who were COVID-19 patients participated in this study. The number of CD4+ and CD8+ cells was assessed, then correlation analysis was performed with the Spearman test, p<0.05.
Results: The correlation between CD4+ and CD8+ has a value of R = 0.875 and p<0.01. This shows that CD4+ and CD8+ have a strong positive correlation and are statistically significant.
Conclusion: The increase in the number of CD4+ cells will be followed by an increase in the number of CD8+ cells in COVID-19 patients at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia
Psychological Stress Induced Recurrent Genital Herpes: A Case Report
Get PDFBackground: Herpes simplex virus type 2 (HSV-2) infection can be caused by genital herpes with a high recurrence rate. Recurrent genital herpes affected patients’ quality of life. Precise management is needed to prevent the progression of the disease.
Case presentation: This study reported a 34 years old male with recurrent genital herpes. The patient developed painful vesicles in the genital area, which turned into an ulcer. History of genital herpes and gonorrhoea urethritis were reported and had been treated. The patient had a history of having unprotected sexual intercourse with multiple partners and reported having psychological stress within 1 month. DLQI score was 12, and the DASS score was 5-85, which confirmed that the patient had anxiety. Vesicles and erosion were found in the genital area. Tzanck test showed multinucleated giant cells with borderline anti-HSV-2 IgG serologies in 2 occasional evaluations. Acyclovir 3x400 mg for 5 days was used as therapy, and no lesion was found at follow-up.
Conclusion: Psychological stress was found to be a risk factor for recurrent genital herpe
Antibacterial Activity of Moringa Plants (Moringa oleifera Lam.) to Overcome Antibiotic Resistance: A Systematic Review
Get PDFAntibiotic resistance This causes the performance of synthetic antibiotics to decrease, so it is necessary to search for natural antibiotics. Moringa plant (Moringa oleifera Lam.) has antibacterial activity proven to inhibit and kill pathogenic bacteria and Multi-Drug Resistance (MDR)article review aims to collect data related to testing the antibacterial activity of Moringa plants as an effort to overcome antibiotic resistance. The method follows the PRISMA-2020 protocol by searching data on PubMed and ScienceDirect media using the keywords: "Antibacterial activity" and "Moringa oleifera". The data selection uses the Rayyan application by considering the inclusion and exclusion criteria that have been set. The final results obtained are 95 data which are experimental journals of the Randomized Control Trial (RCT) type published in 1981-2021. Moringa plants began to be investigated for their activity against MDR bacteria in 2012 and became a sign that research was already in the direction of finding solutions. Antibacterial testing was carried out in vitro (10 studies) and in vivo (1 study). The leaves have been thoroughly tested for their activity against Methicillin-Resistant Staphylococcus aureus (MRSA). The results of in vitro study obtained the range of zone of inhibition, minimum inhibitory concentration, and minimum kill concentration, respectively: 8.3-12 mm; 0.25-20 mg/ml; 0.50-20 mg/ml study in vivo showed that there was the healing of MRSA infection wounds in test animals
Intrahepatic Cholestasis due to Cytomegalovirus Infection and Extrahepatic Cholestasis due to Sludge Bile with Confirmed COVID-19
Get PDFBackground: Human Cytomegalovirus (CMV) is a Beta-Herpes virus that leads to congenital infection in 0.4% to 2,3 % of all newborns. Diagnosis of CMV infection includes the culture of the nasopharynx, saliva, and urine. Serologic tests are also beneficial for CMV diagnosis. IgM CMV-specific antibodies can be monitored. Biliary sludge is a mixture of particulate solids that have precipitated from bile. Laparoscopic cholecystectomy offers the most definitive therapy for biliary sludge.
Case presentation: A 2-month-old boy complained yellow appearance since the age of 1 week ago. Looks pale. Defecation was sometimes colored putty since the age of 2 weeks. Blood laboratory examination with hemoglobin 8,7 gr/dL, Prothrombin time, activated partial thromboplastin time, and liver function were increased. Bilirubin, alkaline phosphatase, and Gamma GT were increased. Two-phase and abdominal USG were biliary atresia. PCR CMV examination with urine and blood sample was positive. Head USG was consistent with CMV infection. Cholangiography showed sludge bile with liver cirrhosis. Therapy gansiklovir IV for 14 days then gansiklovir per oral for 6 months.
Conclusion: Cholangiography is the definitive diagnosis for biliary sludge. CMV is a congenital infection that causes asymptomatic to multiple severe symptoms, so it is necessary to monitor children for adherence to treatment, improve nutritional status and reduce morbidity and mortality rates
Preventive Effects of Vitamin C on Cataracts: In Vivo Study
Get PDFBackground: A cataract is a disease caused by various factors, one of which is the aging process. With increasing age, the formation of free radicals will cause pathological reactions in the lens and other toxic compounds, resulting in oxidative reactions. Administration of vitamin C injection as an antioxidant can reduce the reactivity of free radicals caused by oxidative reactions in cataract lenses induced by sodium selenite. This study aims to determine the preventive effect of vitamin C administration on selenite-induced cataracts based on the value of malondialdehyde (MDA) levels.
Methods: The experimental study used 30 rats which were then divided into 5 treatment groups (P1, P2, P3, P4, and P5). Lenses were extracted for the measurement of malondialdehyde. The value of MDA levels was then analyzed using the One-way ANOVA statistical test.
Results: Statistically, there was no significant difference in MDA levels in each treatment group. Analysis of the difference in mean MDA between the 2 groups showed that the average MDA levels of mice in groups P4 and P5 were relatively lower than P2 and P3, but higher than P1.
Conclusion: Giving vitamin C was able to reduce MDA levels (a marker of oxidative stress) better than the group that did not receive vitamin C, but not statistically different
Comparison of Central Corneal Thickness and Lamina Cribrosa Thickness in Ethnic Indians and Ethnic Malays as Predictors of Glaucomatous Optic Neuropathy
Get PDFBackground: Glaucoma poses a public health problem because it is the second leading cause of blindness after cataracts. A thinner central corneal thickness (CCT) is also a contributor to the development of primary open-angle glaucoma (POAG). Lamina cribrosa (LC) is a structure of the optic nerve head (ONH). LC structural changes such as thinning, posterior displacement, and connective tissue deficiency are associated with the mechanism of retinal nerve fiber layer (RNFL) thickness damage, leading to glaucomatous optic neuropathy.
Methods: Cross-sectional analytic observational study. A total of 36 eyes from 36 research subjects participated in this study. Data analysis was carried out using SPSS version 25. Then, univariate and bivariate analyzes were carried out to see the difference in CCT and LC thicknesses.
Results: The average CCT in ethnic Indians is 514.33 ± 14,142 μm and in ethnic Malays, 542.06 ± 17,234 μm. In this study, there were differences in the average CCT in Indian ethnicity and Malay ethnicity, which was statistically meaningful with a p-value = 0.000.
Conclusion: There are differences in the average central corneal thickness and lamina cribrosa thickness in ethnic Indians compared to ethnic Malays, where the central corneal thickness and lamina cribrosa thickness in ethnic Indians are thinner than ethnic Malays