E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Unexpected Infective Endocarditis in Corrected Congenital Heart Disease: A Case Report
Get PDFObjective: To describe patients with corrected Congenital Heart Disease (CHD) who experienced Infective Endocarditis (IE).Methods: Two cases of IE were observed in 2019. The first case involved a 36-year-old woman with previous percutaneous transcatheter perimembranous ventricular septal defect (VSD) closure four months before admission. Echocardiography showed vegetation at noncoronary cusps of the aortic valve. Patient received antibiotics for six weeks and underwent surgery for evacuation of vegetation and device, along with VSD closure with a cardiovascular patch (Gore-tex). The second case involved a 43-year-old woman with a history of surgical closure in secundum atrial septal defect (ASD) by pericardial patch two months before admission. Echocardiography showed vegetation at the tricuspid valve. Patient received antibiotics for four weeks and planned for surgery to evacuate vegetation. Results: IE is one of the major complications in CHD, whether uncorrected, treated, or corrected. The risk of IE increased with an invasive procedure. Post closure IE is rare. Poor dental hygiene and immunocompromised also increased patient's risk to be exposed to IE as shown in the first patient who had dental caries and the second patient who was on methylprednisolone for post-surgical pericardial effusion treatment. Conclusion: The risk of IE increases with invasive procedures in CHD patients. Although the incidence of IE is quite rare, its possibility should become of a serious concern among physicians
Renal Parameters in Mild, Moderate, and Chronic Cigarette Smokers
Get PDFObjective: To explore the link between cigarette smoking and kidney function through renal parameter assessment.Methods: The present study was performed at the Department of Biochemistry Santosh Medical College, Ghaziabad, India, from September 2019 to April 2021. In this study, 140 subjects were included, out of which 35 were non-smokers, 35 smoked <5 cigarette per day, 35 smoked 5-10 cigarette per day, and the remaining 35 smoked more than 10 cigarettes per day.Results: Blood urea, serum creatinine, urinary albumin, and uACR levels were found to increase significantly (p<0.001) in smokers as compared to non-smokers. These increases were higher among chronic cigarette smokers (p<0.001) as opposed to mild and moderate smokers. In contrast, serum uric acid, e-GFR, and urinary creatinine levels decreased significantly (p<0.001) in smokers when compared to non-smokers, with a higher decrease observed in chronic cigarette smokers (p<0.001) as opposed to the mild and moderate cigarette smokers.Conclusion: Alterations in urinary albumin, serum urea, serum creatinine, urinary creatinine, and e-GFR are associated with the risk of renal dysfunction
Larvicidal Effects of Citrus Peels Extracts against Culex Pipiens Mosquitoes
Get PDFBackground: Mosquitoes transmit severe diseases such as malaria, lymphatic filariasis, dengue fever, and yellow fever. These diseases result in significant morbidity and mortality in humans around the world. This study aimed to provide information on the larvicidal potential of different Citrus species peels against Culex mosquito larvae.Methods: Ethanol extracts of the peels of four Citrus species, such as Citrus sinensis (sweet orange), Citrus reticulata (tangerine), Citrus latifolia (lime), and Citrus paradisi (grape) fruits were tested for larvicidal properties against Culex pipiens at different concentration (3 mg, 5 mg, 7 mg and 8 mg in 100 mL) on 25 larva per concentration. Percentage mortality was recorded for each of the concentrations used. Results: Only Culex latifolia induced the death of all the mosquito larvae (100%) at 5 mg/mL concentration of the extract, meanwhile Culex reticulata resulted in the lowest mortality rate (80%). However, a hundred percent (100%) mortality of the larvae, was observed at 8 mg/mL of all the types of extracts evaluated.Conclusion: The result indicates that the peels of these Citrus species, especially Culex latifolia, hold potential for control of Culex pipiens mosquito larvae
Clinical Features and Outcomes of Patients with Tetanus at Dr. Hasan Sadikin General Hospital Bandung 2015–2019
Get PDFBackground: Tetanus is a disease characterized by painful muscle spasms all over the body, which still becomes an important health issue worldwide, particularly in developing countries due to the high mortality rate. The clinical features also affect the mortality rate of adult tetanus patients. Tetanus severity score (TSS) is a prognostic scoring system developed in Vietnam that uses clinical features to predict the mortality rate in adult tetanus patients. The aim of this study was to describe the clinical features and outcomes of adult tetanus patients using TSS.Methods: A descriptive, cross-sectional study with a total sampling method was conducted between 2015 and 2019. A total of 71 medical records of adult generalized tetanus patients in the Department of Neurology Dr. Hasan Sadikin General Hospital Bandung were collected to analyze the clinical features and outcomes using TSS. Statistical analysis was performed using SPSS software ver. 25.0.Results: Among seventy-one tetanus patients, 62 (87.3%) were male, and the average age was 55.2±11.2 years. More than half of the patients (71%) were having grade III or worse and experienced dysautonomia complications (57.7%). The mortality rate was 38% and those who survived at discharge, 88.64% had TSS score <8, whereas 37.04% who died had TSS score ≥8.Conclusions: Tetanus in Bandung has a high mortality rate. Those who have died have high TSS scores, while the survivors have low TSS scores, suggesting that the TSS is a prospective scoring to predict the mortality rate in patients with tetanus in Indonesia
Intravenous Dexamethasone as Prophylaxis Against Laryngeal Edema Associated with Changes in Sound Quality in Patients Undergoing Total Thyroidectomy
Get PDFThyroidectomy is a relatively safe surgical procedure for thyroid gland removal with a with mortality and morbidity rates of less than 2–3%. Complication in the form of sound changes often goes unnoticed in post-thyroid patients despite its high incidence rate, i.e., 87% of all surgical cases. Laryngeal edema as the underlying cause can be triggered by intubation or extubation during anesthesia; malfunction of the strap muscles; surgery that directly causes injury to the superior laryngeal nerve; and recurrent laryngeal nerve injuries. Several studies on the use of dexamethasone to prevent or reduce laryngeal edema that occurs after thyroidectomy have been conducted with controversial results. This study was conducted to solve this controversy. This was a double-blind randomized prospective study on thyroid tumors patients who underwent thyroidectomy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from December 2020 to May 2021. This study evaluated dexamethasone effects on the patient’s sound changes using the Sound Handicap Index (VHI) questionnaire before surgery, day 1 after the surgery, and day 7 after the surgery. Analysis showed that the VHI significantly decreased on day 1 (p<0.01) and on day 7 (p<0.01), and the difference between the VHI on day 1 (D-1) and day 7 (D-7) was significant (p<0.01). When analyzed using the bivariate analysis, no statistically significant difference was found between the VHI variable before surgery, D-1, and D-7and VHI H7 in the group of patients using dexamethasone and without dexamethasone. Dexamethasone administration has no significant effect on laryngeal edema associated with changes in sound quality
BMI and TLC increase Neoadjuvant Chemotherapy Response in Patients with Locally Advanced Breast Cancer
No full textAnthracycline-based neoadjuvant chemotherapy is the recommended therapy for locally advanced breast cancer (LABC) patients. Unfortunately, no study has reported the relationship between body mass index (BMI), total lymphocyte count (TLC), and responses to this type of chemotherapy. This study aimed to determine the relationship between BMI, TLC, and response to doxorubicin/epirubicin neoadjuvant chemotherapy in LABC patients. A retrospective cohort design was applied to medical records of LABC patients undergoing neoadjuvant chemotherapy at Ulin General Hospital Banjarmasin, Indonesia, from July to December 2021. BMI and TLC data were assessed based on the values before chemotherapy, while the chemotherapy response was measured using the RECIST 1.1 criteria after 3 cycles. Multinomial logistic regression test with 95% confidence level was used to analyze these data. The results showed that as many as 71% of patients experienced a Partial Response (PR), while 5% and 23% of the patients demonstrated Stable Disease (SD) and Progressive Disease (PD), respectively. Each increase in BMI of 1 kg/m2 was significantly associated with an increase in the occurrence of PR and PD by 1.26 times and 1.29 times, respectively, when compared to the occurrence of PD. Meanwhile, an increase in TLC of 100 cells/mm3 was associated with an increase in the occurrence of PR by 6.83 times and an increase in the occurrence of SD. of 6.94 when compared to the occurrence of PD. Therefore, there is a significant relationship between BMI, TLC, and response to anthracycline-based neoadjuvant chemotherapy in LABC patientsNeoadjuvant chemotherapy, especially anthracycline based, is the recommended therapy for Locally Advanced Breast Cancer (LABC). There has been no study reported the relationship between Body Mass Index (BMI) and Total Lymphocyte Count (TLC) with neoadjuvant chemotherapy response in patients with LABC. The purpose of this study is to determine the relationship between BMI and TLC with the response to anthracycline-based neoadjuvant chemotherapy in LABC patients. This study applies a retrospective cohort design. Each increase in BMI of 1 kg/m2 is significantly associated with an increase in the occurrence of PR by 1.26 times compared to the occurrence of PD (aRR 1.26, 95%CI 1.085-1.458, p = 0.002), and every increase in BMI of 1 kg/m2 is significantly associated with an increase in the occurrence of SD by 1.29 times compared to the occurrence of PD (aRR 1.29, 95%CI 1.034-1.615, p = 0.024). Meanwhile, an increase in TLC of 100 cells/mm3 with an increase in the occurrence of PR by 6.83 times compared to the occurrence of PD (aRR 6.83, 95%CI 2.213-21.063, p = 0.001), and an increase in TLC of 100 cells/m3is significantly associated with an increase in the occurrence of SD. of 6.94 compared to the occurrence of PD (aRR 6.9 4, 95%CI 1.419-33.929, p = 0.017). It can be concluded that there is a significant relationship between BMI and TLC with the response to anthracycline-based neoadjuvant chemotherapy in LABC patients.
Role of Surf Redfish (Actinopyga mauritiana) in Wound Incision Healing Activities of Diabetic Mice
Get PDFIt is estimated that 6% of the US population suffer from diabetes with 15% of them experience diabetic foot. Several studies have explored the various benefits of sea cucumber for human being, including its antioxidant nature. This study aimed to investigate the effect of surf redfish, one species of the sea cucumbers, in diabetic wound healing. This was an animal experimental study performed at the Pharmacology and Pharmaceutical laboratory of the Faculty of Pharmacy, Universitas Tjut Nyak Dhien Medan, Indonesia, during the period of February- July 2019. Twenty five mice in diabetic condition were divided into five groups: control, standard, ethanol extract of surf redfish-1, ethanol extract of surf redfish-2, and ethanol extract of surf redfish-3 3. The surf redfish was obtained from Lamreh Village in Aceh and the ethanol was extracted using the maceration method. The parameters used for evaluating the efficacy of surf redfish ethanol extract were blood glucose level, length of wound incision, and histopathological features. Surf redfish extract presented a significant reduction of blood glucose level which that followed the increase in the dose of the ethanol extract (p-value <0.05) where the most significant reduction was seen in the group with the highest dose on the last day. This trend was also seen for the length of the wound, where the reduction was significantly higher in treatment groups when compared to control (p-value <0.05). The histological study also confirmed the improvement in the clinical appearance of wound by showing significantly increased fibroblast cell number and collagen density (p-value <0.05). Overall, the surf redfish can help better incision's wound healing in diabetic condition
Secondary Chronic Immune Thrombocytopenia in Diffuse Large B-cell Lymphoma: A Rare Case Report
Get PDFObjective: To present a case of rare secondary chronic immune thrombocytopenia in diffuse large B-cell lymphoma.Methods: A case of secondary ITP associated with diffuse large B-cell lymphoma (DLBCL) in a 58-year-old woman suffering from hemorrhagic tendencies that was refractory to conventional treatments of ITP was reported. This case is a rarity because there are not many cases of secondary chronic ITP due to DLBCL have been reported to date.Results: A 58-year-old woman was diagnosed with ITP around 11 months before she was admitted to the Emergency Room with bleeding. Previous treatment with steroid and azathioprine was only temporarily effective. During the course of treatment, splenomegaly and lymphadenopathy were identified, but lymph node biopsy was delayed by the thrombocytopenia. The drug was then replaced to the eltrombopag, which showed good response. However, the patient had to undergo splenectomy because of the mechanical effect of splenomegaly, with the biopsy result showed DLBCL. Immune thrombocytopenia then went into a complete remission after splenectomy.Conclusion: In cases of ITP that are refractory to conventional treatments, a thorough search for secondary ITP might be helpful, even if no underlying disorder is detected at the initial presentation
Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS)
Get PDFObjective: To describe an unusual case of drug reaction with eosinophilia and systemic symptoms presenting as fever of unknown origin (FUO) and the diagnostic hurdles that come with the presence of differential diagnosis of FUO, which is tuberculous lymphadenitis.Methods: A 34-year-old female with a chief complaint of fever that has lasted for 3 weeks accompanied with jaundice and skin rashes for 2 weeks was admitted with an indication of FUO. She had a history of carbamazepine consumption for trigerminal neuralgia 2 months prior. Cervical lymphadenopathy was palpable bilaterally and hepatomegaly, elevated liver enzyme, as well as hyperbilirubinemia were observed. After excluding differentials for many causes of prolonged fever, patient was treated for Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) and was given intravenous steroid injections. Fine needle aspiration biopsy was performed for her cervical lymphadenopathy.Results: Biopsy presented a mix of sialadenitis and tuberculous lymphadenopathy. Clinical improvement was observed on the second day after steroid administration. Patient was discharged on the seventh day after steroid administration. Conclusion: FUO is one of the possible manifestations of DRESS; however, thorough investigation still needed to be done considering the possibility of more than one entity of disease that can cause FUO in patients, such as tuberculous lymphadenopathy seen in this case