Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Morbus Hansen Multibacillary Type Mid Borderline: A Case Report
Get PDFBackground: Morbus Hansen (MH) is a granulomatous infectious disease caused by an obligate intracellular pathogenic bacterium, Mycobacterium leprae (M. leprae). Cardinal signs of Hansen's morbus (MH) include patches of numb skin, thickening of the peripheral nerves, and acid-fast bacteria (AFB) on a skin smear or biopsy. This case report aims to establish the diagnosis of mid borderline (BB) MH with clinical and histopathological examination.
Case presentation: A 44-year-old woman presented with red patches on her face and body 1 month ago. Madarosis and multiple erythematous plaques confluent, poorly demarcated, raised edges, atrophic center with some smooth shiny and some rough surfaces found in the facial region and superior extremities et al. bilateral inferior with bilateral auricular infiltrates. A sensory examination of the lesion showed decreased sensitivity to pain and temperature. Skin-slit smear examination showed AFB with bacterial index (IB) +2 and morphological index (IM) 30%. On histopathological examination with hematoxylin and eosin staining, Grenz zone appeared, epithelioid granuloma affecting the epidermis, no lymphocytes, and no giant Langhans cells were found, and nerves were surrounded by lymphocytes and granulomas. On fite-faraco staining, BTA was obtained with IB +3 and IM 30%. The diagnosis of MH type BB was established, and the patient was given multidrug therapy (MDT) multibacillary (MB).
Conclusion: Morbus Hansen type BB has a typical histopathological picture of granulomas composed of mature epithelioid cells, Grenz zone, AFB, enlarged and swollen nerves surrounded by lymphocytes or infiltrated with granulomas without damage. After 3 months of therapy, there was a decrease in IB and IM on AFB examination
Serum Vitamin D Levels Related to Cognitive Function in Chronic Kidney Disease Patients
Get PDFBackground: Vitamin D acts as a neuroprotector and modulator in the central nervous system. Hypovitaminosis is a risk factor for cognitive dysfunction. Hypovitaminosis D and impaired cognitive function are common in patients with chronic kidney disease. Impaired cognitive function is comorbid that can increase the morbidity and mortality of patients with chronic kidney disease. This study aims to assess the relationship between serum vitamin D levels and cognitive function in patients with chronic kidney disease.
Methods: This research is an observational study with a cross-sectional approach. A total of 60 research subjects participated in this study. Sociodemographic data, cognitive function, and vitamin D levels were analyzed in this study. Data analysis was performed with SPSS 25 to perform univariate and bivariate tests.
Results: The impaired cognitive function was found in 56.7% of CKD patients. The median serum vitamin D level of patients with chronic kidney disease with impaired cognitive function was 30.80 ng/mL and without impaired cognitive function 42.98 ng/mL. There was a significant relationship between serum vitamin D levels and impaired cognitive function (OR=4.125, p=0.035). The cut-off point of serum vitamin D levels associated with impaired cognitive function in CKD patients was 34.8 ng/mL (sensitivity 64.7% and specificity 69.2%).
Conclusion:There is a significant relationship between serum vitamin D levels and the incidence of cognitive dysfunction in patients with chronic kidney disease. The cut-off point for serum vitamin D levels associated with impaired cognitive function in chronic kidney disease is 34.8 ng/mL
Effect of Radon and Lung Cancer Risk: A Narrative Literature Review
Get PDFExposure to cigarette smoke has been known to be a major risk factor for lung cancer. Although smoking has long been considered the main cause of lung cancer, about 5 to 25% of lung cancer cases occur in non-smokers. Radon is said to be the second most important cause of lung cancer after smoking. Radon-222 is a chemical element in the form of a highly radioactive gas that comes from the decay of the parent radioactive element, uranium, which is found in the earth's crust. Inhaled radon gas can adhere to the mucosal lining of the airways and damage the airway epithelium. The process of ionizing radiation by alpha particles due to the decay of radioactive substances can cause mutations and chromosomal aberrations, severance of DNA double chains, and formation of reactive oxygen species. (ROS) that cause cell cycle changes, up-and down-regulation of cytokines, and increased production of proteins associated with cell cycle regulation and carcinogenesis. Research on radon and lung cancer has not been widely conducted in Indonesia. This literature review aims to describe radon and its effects on lung health
Microneedling Radiofrequency for Acne Vulgaris and Post-Acne Scarring: A Case Report
Get PDFBackground. There are various therapeutic modalities for acne and post acne scarring, but the best option is to have a safe, effective with affordable cost such as monotherapy or combination therapy. One of the recommended combination therapy for acne vulgaris with atrophic acne scars is microneedling radiofrequency which can improve skin structure.
Case presentation. A 25 years old male with moderate comedonal acne vulgaris and severe scarring. The patient came with complaints of uneven skin surface on both cheeks, forehead and chin which had been felt to increase since 3 years ago. The appearance of acne on the face has been felt since 12 years ago. The patient's parents and sister also had acne complaints. On dermatological examination, on the forehead, temples, cheeks, nose and chin found blackheads, whiteheads, papules, hyperpigmented macules, multiple atrophic acne scars. The treatment choice for this patient is microneedling radiofrequency in combination with topical therapy.
Discussion. The combination of microneedling with radiofrequency is one of the therapeutic modalities for acne vulgaris and also post-acne scarring with minimal side effects. In the evaluation for 2 weeks after the procedure, this patient did not complaint of any adverse events
Treatment of Systemic Lupus Erythematosus with Anti SSA and SSB Positive Pregnancies
Get PDFSystemic lupus erythematosus (SLE) is autoimmune disease that results in inflammation in various organ systems, frequent recurrences in the clinical course characterized by the production of antibodies against core antigens. Pregnancy will trigger flares. Increased intravascular volume in pregnancy can worsen abnormal heart and kidney function. Increasing the glomerular filtration rate by 50% exacerbated previously stable proteinuria. Pregnancy-induced hypercoagulability increases the risk of thrombosis. Anti-Ro/SSA was found in 35% of SLE patients and anti-La / SSB was found in 15% of SLE patients. The presence of Ro and La antibodies puts the fetus at a risk of developing neonatal lupus erythematosus (NLE) 6-13% and can reach up to 25% if the mother has previously given birth to a child with NLE. Neonatal lupus erythematosus including congenital heart block or cutaneous lupus. Congenital heart block (CHB) is a very serious complication. The American College of Rheumatology (ACR) recommends serial fetal echocardiography from 16 weeks of gestation continuing through to 26 weeks. Pregnancies with grade I and II CHB are treated with oral dexamethasone 4 mg daily because fluorinated glucocorticoids such as dexamethasone and betamethasone can cross the placenta, however, this therapy cannot be given in third-degree heart block. Early diagnosis and therapy will reduce the risk of congenital heart block in neonates after birth
The Relationship between Age of Menarche and Body Mass Index (BMI) with Endometriosis Incidence at Dr. Mohammad Hoesin Palembang Period 2018 – 2020
Get PDFBackground. Endometriosis is the presence of endometrial glands and stroma outside the uterus. This study aims to analyze the relationship between age of menarche and body mass index (BMI) with the incidence of endometriosis.
Methods. This study is an analytical observational study with a cross-sectional approach. The samples taken in this study were post-operative patients with gynecological disorders at Dr. Mohammad Hoesin General Hospital Palembang. The sample taken in this study was 62 respondents during the period 2018-2020 with a simple random sampling technique based on inclusion criteria. The research data was processed and analyzed by univariate and bivariate with Chi-square test using SPSS application.
Results. Most of the respondents with endometriosis experienced at the age of menarche <12 years (91.3%) and had a non-obese BMI (73.3%). There was a significant relationship between the age of menarche and the endometriosis incidence (p=0.039). There was no statistically significant relationship between body mass index (BMI) and the endometriosis incidence (p=1,043).
Conclusion. Early menarche can increase the risk of endometriosis. The majority of women with endometriosis in this study had a BMI in the non-obese category (BMI <25)
Capability of Rice Husk Silica on Flexural Improvement in Metal Ceramic Restoration
Get PDFBackground: Metal ceramic restoration (MCR) is a gold standard due to its ability to withstand masticatory forces and aesthetics. However, it frequently appears to experience a fracture in the oral cavity. The ceramics in MCR consist of an opaque dentin and enamel layer, which contain silica to give the ceramic strength. Silica is an abundant material, mainly synthesized from rice husks. The study was aimed to investigate the effect of silica added to commercially opaque porcelain powder in increasing the flexural strength of MCR.
Methods: The research sample was rectangular Co-Cr metal [(25±1) mm × (3±0.1) mm × (0.5 ± 0.05) mm], and opaque porcelain powder and dentin [(8±0.1) mm× (3±0.1) mm ×(1.1±0.1) mm]. White silica powder was synthesized from rice husk by sonication for 270 minutes, characterized by x-ray fluorescence (XRF). Silica was mixed with commercial opaque porcelain powder with various concentrations of 0, 0.5, and 1%, porcelain coating procedure on the centre of the surface metal, followed by sintering at 9500C.
Results: Characterization with XRF showed that the elemental content of pure silica was 83.9%. The average flexural strength value with three-point bending in each sample is 109.67±12.163; 131.26±3.817; and 108.35±4.26. The results of statistical tests using One Way ANOVA stated a significant increase in the flexural strength of MCR (p<0.05) post added the rice husk silica to the commercial opaque porcelain powder.
Conclusion: Adding 0.5% silica resulted in the optimal flexural strength of MCR
Diagnosis and Management of Vesicouterine Fistula (Youssef’s Syndrome): A Case Report
Get PDFBackground. Vesicouterine fistula (VUF) is a rare pathological communication between the uterus or cervix and the bladder. Youssef's syndrome is an atypical presentation of a patient with a vesicouterine fistula, characterized by a triad of cyclic hematuria, amenorrhea, and absence of urinary incontinence. Because of this atypical presentation, the patient may go undiagnosed and patient management will be delayed.
Case presentation. A 39-year-old woman complained of hematuria. The patient underwent a second caesarean section in 2008 and a few weeks after the procedure the patient complained of leakage of urine from her vagina. Six months later the patient complained hematuria on her menstrual cycle and amenorrhea, with absence of urinary incontinence. Ultrasound examination found adhesions between the uterus and vagina, and irregular bladder mucosa. Patient underwent cystoscopy with endometriosis were suspected on vesicovaginal repair scars and a bladder biopsy was also performed with the results of no endometrial stroma and glands then followed by hysteroscopy. Hysteroscopy result showed a 20 mm diameter hole with irregular margins. Subsequently, the patient was treated with hysterorrhaphy laparotomy and fistula repair.
Conclusion. One type of vesicouterine fistula is Youssef's syndrome, which is a complication following a lower segment caesarean section with undiagnosed bladder injury. The diagnosis can be confirmed by cystoscopy, intravenous pyelography, hysterosalpingogram, sonography, and other types of imaging tests. Management of patients with VUF can be conservative, medical, or surgical
Evisceration Versus Enucleation in Ocular Globe Injury
Get PDFEvisceration and enucleation have been acceptable therapeutic modalities to treat not only severe ocular trauma but also various ocular conditions, such as intraocular tumors, endophthalmitis, and blind-painful-cosmetically disfiguring eyes, over the last two centuries. Clinical indications and choices of procedure, whether enucleation or evisceration, vary among institutions, surgeon experience, and severity of structure loss. In the past, enucleation has been preferred by most surgeons for various reasons, including the fear of sympathetic ophthalmia (SO) after evisceration. Despite the possibility of causing SO, anophthalmic socket also has complications, including superior sulcus defect, conjunctival surface changes, implant exposure, fornix/socket contraction, and eyelid malposition. This literature review will discuss indication, technique, and decision with regard to enucleation or evisceration after ocular trauma
Heart Failure Due to Mitral Stenosis Complicated Atrial Fibrillation in Pregnancy
Get PDFBackground. This case report aims to discuss the management of heart failure due to mitral stenosis with complications of atrial fibrillation in pregnancy.
Case presentations. A 35-year-old pregnant woman came to the ER M. Djamil Hospital with complaints of shortness of breath 3 days before being admitted to the hospital. Complaints of shortness of breath accompanied by palpitations felt fast and irregular, appeared suddenly when the patient was resting, and lasted continuously. Physical examination showed a pulse rate of 120-130x/minute, increased jugular venous pressure, and palpable cardiac ictus 1 finger lateral to the left midclavicular at the V intercostal space. ECG examination revealed atrial fibrillation- rapid ventricular response (AF RVR). The patient was diagnosed with atrial fibrillation- rapid ventricular response et causa suspect mitral stenosis NYHA Fc III, et causa rheumatic heart disease.
Conclusion. The management of atrial fibrillation rapid ventricular response in this patient was done by giving digoxin 0.25 mg orally. Patients are given anticoagulants to prevent thromboembolic complications. This patient was advised to undergo valve replacement surgery considering the degree of stenosis, complications, and a thorough assessment