Bioscientia Medicina - Journal of Biomedicine and Translational Research
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The Association between 25-(OH)D Level and Metabolic Control Status in Children with Type 1 Diabetes Mellitus at Dr. M. Djamil General Hospital Padang
Get PDFBackground. Type 1 diabetes mellitus (T1DM) is an autoimmune disease causing the destruction of pancreatic beta cells. This is an incurable condition, but with good metabolic control, an optimal quality of life can be achieved. Glycated hemoglobin (HbA1C) is still considered a reliable parameter of metabolic control. Studies showed vitamin D has a role in controlling glycemic homeostasis in children with T1DM. Calcidiol or 25-(OH)D is the best parameter to determine the level of vitamin D in the blood. This study aimed to evaluate the association between 25-(OH)D with metabolic control status in T1DM children at Dr. M. Djamil General Hospital Padang.
Methods. A cross-sectional study was conducted on 43 pediatric patients with T1DM from July 2019-January 2021. Serum levels of 25-(OH)D were measured by direct CLIA method and classified into deficiency (≤ 20 ng/mL) and insufficiency (21–30 ng/mL). The HbA1C levels were calculated using the HPLC method and classified into good (<7%), adequate (7-8%), and poor (>8%) control. The Chi-square test and ANOVA were used for data analysis. The P-value of < 0.05 was considered statistically significant.
Results. The majority of respondents were girls (53.5%), with 90.7% having a good nutritional status. The mean age at diagnosis was 11.25±2.85 years, and had been known to suffer from T1DM for 2.95±1.74 years. All respondents had abnormal levels of 25-(OH)D (100%), i.e., insufficiency (28%), deficiency (72%), poor (65.1%) metabolic control, and 96.4% of respondents with poor metabolic control had a deficiency of 25-(OH)D. (P-value <0.001).
Conclusion. T1DM patients who have poor metabolic control have very low levels of 25-(OH)D
HIV Drug Resistance Mutations
Get PDFART resistance, according to WHO, is the presence of one or more mutations in HIV that reduces the ability of certain drugs or drug groups to inhibit viral replication. According to the 2019 HIV Drug Resistance Report issued by the WHO, the prevalence of Antiretroviral Therapy (ART) drug resistance is 3%-29%. The prevalence of HIV drug resistance varies by country. In developed countries, the prevalence ranges from 6.6% to 11%. There are two types of resistance to ART: primary and secondary resistance. Primary resistance reflects the acquisition of drug-resistant strains in individuals who have recently been infected and have not received therapy. Secondary resistance occurs after treatment with ART. Resistance to antiretroviral therapy, mainly NRTIs, NNRTIs, and protease inhibitors, is caused by continuous inhibition of the HIV reverse transcriptase enzyme. World Health Organization (WHO) has recommended two NRTIs plus Lopinavir or Atazanavir as a second-line regimen for individuals who have failed treatment with efavirenz or dolutegravir; two NRTIs plus Darunavir and Lopinavir plus Raltegravir are recommended as an alternative due to cost constraints and the fact that Darunavir is unstable in moderately hot conditions
Growth Profile in Pediatric Patients with Diabetes Mellitus at Dr. M. Djamil General Hospital, Padang
Get PDFBackground: Diabetes mellitus (DM) is a glucose metabolism disorder characterized by chronic hyperglycemia that often occurs and is a major health problem. During puberty, increased Growth Hormone (GH) secretion results in increased insulin resistance. This study aimed to describe the growth profile of pediatric patients with diabetes mellitus at Dr. M. Djamil General Hospital.
Methods: A descriptive retrospective study with conducted by collecting data on body height, HbA1C level, and status of puberty from medical records at the pediatric ward of Dr. M. Djamil General Hospital from January 2019 - December 2020.
Results: The sample was 67 (63 T1DM, 2 T2DM, and 2 double DM). Ten of them with short stature (8 with poor metabolic control).
Conclusion: Children with DM may experience growth disturbance
Extraintestinal Amoebiasis: Amebic Liver Abscess in a 48-Year-Old Male Patient
Get PDFBackground: The liver is the most common organ for abscesses. Liver abscesses can be solitary or multiple. Approximately 90% of right-lobe liver abscesses are solitary abscesses, while only 10% of left-lobe abscesses are solitary abscesses. This can occur from hematogenous spread or directly from the site of infection in the peritoneal cavity.
Case presentation: A 48-year-old male patient had been administered into the internal medicine ward with the chief complaint of pain in the upper right quadrant of the abdominal increased 3 days before being admitted to the hospital. The patient also complains that pain increase when the patient moves forward and is influenced by activity. The patient walked like a person who carried his stomach. The patient complained of watery stools 3 months ago in ten days, which frequency two to three times a day. The stools are bloody and slimy. Swelling of an upper right quadrant of abdominal since 1 month ago. Decrease of appetite since 1 month ago. Decrease of body weight since 1 month ago, about 5 kilograms. Fever since 2 weeks ago, not high, disappearing, no chill, no sweat. Nauseous since 1 week ago. The patient was admitted to the hospital with awareness of compos mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 120/80 mmHg, pulse rate 86 times/minute, regular pulse, adequate filling, respiratory rate 24 times/minute, temperature 37ºC. On physical examination, the conjunctiva of the patient’s eyes was anemic. Entamoeba histolytica was found on a routine stool examination.
Conclusion: The main clinical manifestations of amoebiasis are right abdominal pain can be features of iron deficiency anemia and reactive thrombocytosis. Diagnosis is based on the finding of characteristic Entamoeba histolytica in the stool. Metronidazole 500 mg three times daily dose resulted in 80% cure and a dose of 750 mg/three times daily for 10 days gave 100% cure. Treatment of reactive thrombocytosis is by curing the basic disease
Sperm DNA Fragmentation Index: A Comparison Study of Success Rates among Natural, Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF)-Intra Cytoplasmic Sperm Injection (ICSI) Pregnancy Programs
Get PDFBackground: Some studies have reported a relationship between the sperm DNA fragmentation index (DFI) and the rate of fertilization and pregnancy. This study was designed to assess the mean sperm DNA fragmentation in pregnancies that occur in infertile couples, whether in natural pregnancy, intrauterine insemination (IUI), and in vitro fertilization (IVF) – intra cytoplasmic injection (ICSI).
Methods: This research is an observational analytic study with a cross-sectional design. The sample taken in this study were infertile patients that underwent natural pregnancy or IUI or IVF-ICSI at Yasmin Infertility Clinic of Dr. Ciptomangunkusumo Hospital period 2018-2020 with a consecutive sampling technique. The research data was processed and analyzed by the Mann-Whitney test using the SPSS application.
Results: The mean DFI of sperm in men with infertile couples who successfully conceived naturally was 10.7% (mild), while IUI was 20.4% (moderate), and IVF-ICSI was 30.5% (poor). The mean DFI in semen samples of men from infertile couples who underwent a natural program was significantly lower in those who successfully conceived compared to those who did not. Similar results were also shown in the IUI and IVF-ICSI programs, which showed a significantly lower DFI compared to non-pregnant women.
Conclusion: DFI can be applied as a marker for selecting the type of pregnancy program in infertility management
Diagnosis and Management of Refeeding Syndrome
Get PDFRefeeding syndrome (RFS) is described as a syndrome of electrolyte abnormalities and changes in body fluids with metabolic abnormalities in malnourished patients who receive refeeding either orally, enteral, or parenterally. Patients at risk for RFS are patients who have lost 10% of their previous body weight in the last 3-6 months, cancer patients who are on chemotherapy, geriatric patients with malnutrition, and patients with anorexia. Clinical manifestations are caused by electrolyte changes that affect neurons, heart and muscle disorders with various symptoms, and even death. The specific characteristics of RFS are the presence of hypophosphatemia and accompanied by other symptoms of electrolyte imbalance such as changes in sodium levels, changes in glucose, protein, fat metabolism, vitamin B1 deficiency, hypokalemia, and hypomagnesemia. The principle of management of RFS is to correct biochemical abnormalities and electrolyte and fluid imbalances. Preventive steps that can be taken are identifying individuals at risk for RFS, monitoring refeeding and administering an appropriate diet regimen
Effect of Combination of Tamsulosin and Tadalafil in Benign Prostate Hyperplasia Patients on International Prostate Symptom Score
Get PDFBackground: Benign prostate hyperplasia (BPH) is the most common pathological condition that contributes to lower urinary tract symptoms (LUTS) in men. Alpha1-blockers are recommended as first-line therapy for LUTS due to BPH (LUTS-BPH). Phosphodiesterase 5 (PDE5-I) inhibitors, which have been used as first-line therapy for erectile dysfunction, have also been found to be effective in treating LUTS-BPH. However, the appropriate combination therapy strategy is still unclear until now.
Methods: This study used an experimental design on 17 BPH patients on medical therapy. The patient was given Tamsulosin 0.4 mg monotherapy for 7 days and then continued combination therapy with Tamsulosin 0.4 mg and Tadalafil 5 mg for the next 7 days. Total IPSS score, obstruction, irritation, and quality of life (QoL) were assessed before treatment, after monotherapy, and after combination therapy.
Results: The mean age of the research subjects was 62.12 years. Improvements in the total IPSS value, obstruction, irritation, and QoL showed significant changes in both types of therapy compared to the initial value. Combination therapy gave better results than monotherapy, with a mean difference in the decrease in the total IPSS value of 4.41 (p<0.001), obstruction of 3.18 (p<0.001), irritation of 1.41 (p<0.001), and QoL 0.6 (p<0.001).
Conclusion: The combination therapy of Tamsulosin 0.4 mg with Tadalafil 5 mg once a day showed clinically and significantly better results than monotherapy in total IPSS, obstruction, irritation, and QoL values in LUTS-BPH patients
Relationship of Parathyroid Hormone Levels with Uremic Neuropathy in Chronic Kidney Disease Patients
Get PDFBackground: Parathyroid hormone is known as one of the main uremic toxicants, which, if the amount increases in plasma, will affect motor conduction in patients with chronic kidney disease. This study aims to determine the relationship between Parathyroid hormone levels with uremic neuropathy in patients with chronic kidney disease.
Methods: This study was an analytic observational study with a cross-sectional approach, where as many as 42 subjects participated in this study. Data analysis was performed using SPSS using univariate and bivariate, with p<0.05.
Results: There was a difference in the average thyroid hormone levels in neuropathy and without neuropathy, but statistically, it was not different p>0.05.
Conclusion: There is no relationship between parathyroid hormone and uremic neuropathy in patients with chronic kidney disease
Differences in p53 Expression in High-Grade Conventional Osteosarcoma and Giant Cell Tumor of Bone
Get PDFBackground: Osteosarcoma is the most common primary tumor of bone. Generally, patients with osteosarcoma have a poor prognosis. So it is very important to be able to diagnose as early as possible. Histopathologically, osteosarcoma has a variety of types similar to non-malignant lesions, such as giant cell tumor of bone. Therefore, caution is needed in diagnosing because if it is misdiagnosed, it will result in different management. This study aims to look at differences in p53 protein expression in high-grade conventional osteosarcoma and giant cell tumor of bone.
Methods: This observational analytic study used 30 samples from tissue biopsies/surgeries diagnosed with conventional high-grade osteosarcoma and 30 samples of giant cell tumor of bone at the Anatomical Pathology Installation of Dr. Saiful Anwar General Hospital Malang, Indonesia, between 2018-2022. p53 expression was examined using the immunohistochemical staining method. Positive if stained with brown on the nucleus of the cell, the percentage of 500 malignant cells was calculated in the large field of view of the objective lens (x40) randomly. Univariate and bivariate data analysis was performed using SPSS.
Results: The average p53 protein expression in conventional high-grade osteosarcoma was 80.0% ± 26.2, with the lowest value being 19% and the highest value being 100%. Whereas in giant cell tumor of bone, the average p53 expression was 1.7% ± 4.3, with the lowest value being 0% and the highest value being 17.6%. Statistical analysis using the Mann-Whitney test showed that p53 expression in conventional high-grade osteosarcoma and giant cell tumor of bone showed a significant difference (p=0.000).
Conclusion: There is a significant difference between p53 expression in high-grade conventional osteosarcoma and giant cell tumor of bone
The Effect of Giving Fermented Milk Starter Lactococcus lactis D4 Dadih on Obstructive Jaundice: An In Vivo Study
Get PDFBackground: Every 1 person out of 3 people with obstructive jaundice will die from complications of obstructive jaundice. The absence of bile salts causes the loss of the protective layer of the intestinal mucosa, which causes an increase in the permeability of the intestinal wall, triggering the process of translocation of various bacteria from the intestinal tract to the blood circulation so that it can trigger septicemia and sepsis. Dadih or commonly known as ampiang dadih is a fermented buffalo milk product. Dadih contains lactic acid bacteria microbiota, which can function as probiotics fermented milk starter Lactococcus lactis D4 dadih to small intestine in obstructive jaundice in vivo.
Methods: This study was an in vivo experimental study using 30 wistar rats, which were divided into 3 test groups. Observation of the condition of the small intestine was carried out histopathologically to assess the inflammatory process and the condition of the intestinal mucosa. Data analysis was performed using SPSS version 25 using univariate and bivariate methods.
Results: Group 3 showed minimal histopathological inflammation compared to the control and was statistically different, p<0.05.
Conclusion: Giving fermented milk starter Lactococcus lactis D4 dadih was able to reduce the inflammatory response and repair the intestinal mucosa in conditions of obstructive jaundice in vivo studies