Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Management of Earlobe Keloid by Triple Combination Therapy (Core Excision, Fillet Flap, and Intralesional Corticosteroids): A Case Report
Get PDFBackground: Keloid is a growing neoplasm characterized by the proliferation of benign fibroblasts. The chest, shoulders, head, especially the ear lobes, neck, arms, and upper back are the areas most commonly affected by keloids. The use of a fillet flap allows dissection of the keloid core and leaves loose skin for wound closure. This study aims to describe the surgical management of keloids in the auricular region using the core excision technique with a keloid fillet flap with a combination of corticosteroid injections.
Case presentation: A 54-year-old man came with the main complaint of a red lump with hard consistency and itching on the right ear. The management of this patient was surgery using the core excision technique with a keloid fillet flap followed by intra-operative intralesional and immediate post-operative corticosteroid injection and then programmed for corticosteroid injection at the next follow-up. Post-operative therapy was given cefixime 2x100mg and oral analgesic mefenamic acid 3x500mg for 5 days.
Conclusion: Keloid surgery is the treatment of choice because it produces good cosmetic results quickly. Routine follow-up and additional therapy are required to prevent a future post-operative recurrence
Exacerbation of Psoriasis Vulgaris Induced by Vaccine COVID-19 in HIV Patient: A Case Report
Get PDFBackground: Psoriasis is a chronic and inflammatory skin disease. Many triggering factors can cause exacerbation of psoriasis, such as infection, trauma, and drugs. Several vaccines are known to cause new lesions or exacerbation of psoriasis, including Bacillus Calmette-Guerin (BCG), influenza, tetanus-diphtheria, and pneumococcal polysaccharide. In the COVID-19 pandemic, the COVID-19 vaccine is known to cause the appearance of new lesions or exacerbation of psoriasis.
Case presentation: A woman, 31 years old, came to the clinic with itchy reddish patches with white scales on her face, chest, stomach, back, arms, and both legs, and increased since 2 weeks ago. Previously, the patient got the first COVID-19 vaccine (Sinovac), and three days later, red patches appeared with white scales on the chest, stomach, and back. The patient had been diagnosed with psoriasis 3 years ago. Dermatology examination showed reddish patches with white scales on the face, chest, stomach, back, arms, and both legs. Auspitz sign and Kaarvetsvlek phenomen were positive. PASI score was 9,2. Dermoscopy examination showed red dot distribution on light pink background and white scales. She was treated with desoximetasone cream 0,05% twice a day and cetirizine tablet 10 mg once a day. After 2 months of therapy, reddish patches were decreased, and the PASI score was 6,9.
Conclusion: COVID-19 vaccine can cause exacerbations in psoriasis patients, but this vaccine can still be given to psoriasis patients. It is based on the documented efficacy of the COVID-19 vaccine in the prevention of severe COVID-19 infection and fatality. Psoriasis patients should be consulted before getting vaccinated for COVID-19, and prompt clinical visits should be available if exacerbation develops
Diagnosis and Management of Chronic Appendicitis in Children: A Case Report
Get PDFBackground: Abdominal pain was one of the most complaints in children. Chronic appendicitis was the common cause of recurrent abdominal pain. The incidence of this case was 1,5% of all appendicitis cases. The manifestation was not specific, and one of the treatment options was surgical with laparotomy or laparoscopy methods.
Case presentation: A 10-year-old boy came to the outpatient clinic of gastroenterohepatology with a diagnosis of abdominal pain caused by chronic appendicitis differential diagnosis of chronic gastritis with abdominal pain, especially the pit of the stomach moving to the right waist since 3 months ago. Physical examination of the patient showed the general condition was moderate, conscious, and normal vital signs. Abdominal distension was absent, tenderness in the lower right abdomen was present, and the pain was present in the lower right abdomen. There was contralateral tenderness in the left lower abdomen. An appendicogram examination shows chronic appendicitis. The patient was consulted for pediatric surgery for appendectomy and later controlled to a surgical outpatient clinic after discharge.
Conclusion: Chronic appendicitis usually shows unspecific manifestation and physical examination. Early diagnosis and surgical treatment are options to treat appendicitis in children
The Role of Urinary Potassium Examination on the Progressivity of Chronic Kidney Disease: A Narrative Literature Review
Get PDFKidneys play an important role in potassium homeostasis. The important role of the kidneys in maintaining potassium balance is reflected in the high level of potassium disturbances in patients with decreased kidney function, especially patients with severely decreased renal function and patients who have comorbidities, such as diabetes, hypertension, or heart failure. Chronic kidney disease is characterized by abnormalities of kidney structure or function that persist for more than 3 months, have many complex causes, and have a major impact on global health status. There are several methods to measure the amount of potassium intake consumed, including a food frequency questionnaire, dietary recall, temporary urine potassium examination, and 24-hour urine potassium examination. The standard gold measurement for evaluating urinary potassium excretion is through 24-hour urine collection. This literature review aims to describe the role of urinary potassium excretion in assessing the progression of chronic kidney disease
Psychosomatic Aspect of the COVID-19 Pandemic
Get PDFA pandemic is an epidemic of an infectious disease that spreads over a wider area, multiple continents, or the entire world at the same time. Since COVID-19 was declared a pandemic on March 11th, 2020, the world has entered a global emergency phase. The COVID-19 pandemic has changed the way of life and become a stressor in this century. Various factors become stressors during a pandemic. Many people experience negative emotions, such as fear, anxiety, and depression, during the COVID-19 pandemic. When negative emotions are no longer controlled, they will have a negative effect on the autonomic nervous system and cerebral cortex, causing psychosomatic and somatic symptoms. Many studies have shown a significant relationship between perceived stress and psychosomatic complaints. Research has also shown that stress during the COVID-19 pandemic is associated with an increase in psychosomatic symptoms. In the future, negative emotions during a pandemic, if not managed properly, can lead to post-traumatic stress disorder (PTSD). Peoples who are vulnerable to mental disorders due to COVID-19 include people with chronic diseases. Stressors during a pandemic can exacerbate anxiety, depression, and chronic stress in people with chronic diseases, causing exacerbations of chronic diseases, increasing somatic symptoms, and decreasing immune responses, resulting in increased infection and mortality risk
Relationship between Molecular Subtype, Degree of Differentiation, and Lymph Node Metastasis with Survival of Breast Cancer Patients at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Breast cancer has the highest incidence of all cancers in women worldwide. A molecular subtype of breast cancer, degree of differentiation, and lymph node metastasis are prognostic and predictive factors of breast cancer. This study aims to explore the relationship between molecular subtype, degree of differentiation, and lymph node metastasis with overall survival and disease-free survival of breast cancer patients at Dr. M. Djamil General Hospital Padang.
Methods: This study was an analytic observational study with a retrospective cohort approach using secondary data from 68 subjects. The test variables in this study were the molecular subtype of breast cancer, the degree of differentiation, and lymph node metastasis which were obtained from secondary data and medical records. Another test variable is patient survival, namely overall survival (OS) and disease-free survival (DFS). Data analysis with the help of SPSS software in univariate, bivariate, and multivariate.
Results: Patients with lymph node metastases were 7.94 times more likely to experience an event (death) (HR=7.94 95% CI: 0.91–78.2). Patients with lymph node metastases were 10.2 times more likely to experience an event (recurrence) (HR=10.2 95% CI: 1.03–101.1).
Conclusion: Lymph node metastases are the factors most related to survival (overall survival and disease-free survival) of breast cancer patients at Dr. M. Djamil General Hospital, Padang, Indonesia
Correlation of Neutrophil to Lymphocyte Ratio (NLR) Values to Ejection Fraction, Fraction Shortening, and E/A Ratio in Children with Rheumatic Heart Disease (RHD) at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Monitoring the performance of the cardiac function is a must in monitoring patients with rheumatic heart disease (RHD). Echocardiography is the main diagnostic tool that plays a role in monitoring heart function, but the existence of this tool is only in tertiary health services and generally requires special expertise. This study aims to determine the correlation between the neutrophil to lymphocyte ratio (NLR) and markers of cardiac function performance on echocardiography, namely ejection fraction, fraction shortening, and E/A ratio in children with rheumatic heart disease at Dr. M. Djamil General Hospital, Padang, Indonesia.
Methods: This was an analytical observational study with a cross-sectional approach. A total of 34 subjects were included in this study. Data analysis using SPSS was univariate and bivariate, with p<0.05.
Results: There was a correlation between the NLR value and the echocardiographic ejection fraction (EF) parameter (p>0.05) with a very weak correlation strength, while the correlation between the NLR value and the FS echocardiography parameter (p<0.05), the direction of the correlation formed is positive with a strong correlation weak (r=0.388). As for the correlation of NLR values with echocardiographic parameters E/A (p<0.05), the direction of the correlation formed was positive with a weak correlation strength (r=0.353).
Conclusion: There is a weak correlation between NLR values with FS and E/A echocardiographic parameters and no correlation between NLR and EF echocardiographic parameters in rheumatic heart disease patients at Dr. M. Djamil General Hospital, Padang, Indonesia
Overview of Bilateral Retinoblastoma at Dr. M. Djamil General Hospital, Padang, Indonesia
Get PDFBackground: Retinoblastoma is the most common intraocular primary malignant tumor in children. In the United States, cases of retinoblastoma are estimated to be found in 1 in 18,000 children under 5 years. The incidence of retinoblastoma ranges from 1:14.00 to 1:34.000 live births. The highest incidence occurs in developing countries. This study aimed to provide a clinical picture of bilateral retinoblastoma at Dr. M. Djamil General Hospital, Padang, Indonesia, as basic data for further policy-making in order to optimize services related to the management of bilateral retinoblastoma.
Methods: This study was a descriptive observational study with 29 study subjects. Sociodemographic, clinical, and management data are presented descriptively. Data analysis was performed with the help of SPSS software version 25.
Results: Based on the age group, the majority of bilateral retinoblastoma cases were less than 5 years old, with the most age range being 3-4 years. The majority of therapeutic management for cases of bilateral retinoblastoma is exenteration in combination with chemotherapy.
Conclusion: A combination of surgery and chemotherapy is the most frequently used treatment for bilateral retinoblastoma at Dr. M. Djamil General Hospital, Padang, Indonesia
Comparison of Outcomes in Critically Ill Patients Installed with Mechanical Ventilation Performed Early and Late Tracheostomy at Dr. M. Djamil General Hospital Padang
Get PDFBackground: Tracheostomy is an alternative that is widely used as airway access after the use of a ventilator in the care of critically ill patients. Several factors are known to influence the outcome in patients undergoing tracheostomy. This study aimed to compare the outcomes of critically ill patients installed with mechanical ventilation performed early and late tracheostomy in Dr. M Djamil General Hospital, Padang, Indonesia.
Methods: This study was an analytical observational study with a cross-sectional approach. A total of 97 research subjects participated in this study. Data analysis was carried out with the help of SPSS software in a univariate and bivariate manner between tracheostomy time (early and late) with patient outcomes in the form of death and length of stay.
Results: There was a statistical difference in the mortality rate in critically ill patients with mechanical ventilation performed early and late tracheostomy, p = 0.014. There is a statistical difference in the length of stay in the intensive care unit in critically ill patients with mechanical ventilation performed early and late tracheostomy with p = 0.000.
Conclusion: There are differences in outcomes in the form of mortality and length of stay in critically ill patients who have tracheostomy installed at Dr. M. Djamil General Hospital Padang, Indonesia
Characteristics of Cholelithiasis Patients in Dr. Achmad Mochtar General Hospital Bukittinggi on January 2019 - December 2020
Get PDFBackground. Cholelithiasis is a condition where there are stones in the gallbladder or the common bile duct or both. This study aims to describe the characteristics of cholelithiasis patients in RSUD Dr. Achmad Mochtar Bukittinggi.
Methods. This research is a descriptive observational study on the incidence of cholelithiasis in hospitals. Dr. Achmad Mochtar Bukittinggi period January 2019 – December 2020. A total of 224 research subjects participated in this study. Secondary data was collected from medical records of research subjects, including data on age, gender, body mass index, clinical symptoms, and type of surgery. Data analysis was carried out with the help of SPSS 25 software.
Results. Cholelithiasis was most commonly found in the age group over 50 years (47.8%), normal BMI (46%) cases. The most complained symptom in cholelithiasis patients in this study was abdominal pain (61.6%). All cholelithiasis patients (100%) in this study underwent laparoscopic cholecystectomy surgery.
Conclusion. Cholelithiasis patients who underwent surgery in hospitals. Dr. Achmad Mochtar Bukittinggi for the period January 2019 – December 2020 were 224 patients. The majority of patients over 50 years of age, women, had a normal BMI. The patient frequently complained of abdominal pain and all had undergone laparoscopic cholecystectomy