E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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High-risk Neuroblastoma in Young Adult and Long Term Survival with Multimodal Therapy: A Case Report
Get PDFObjective: To present a case of high-risk, stage four neuroblastoma in a 20-year-old woman who survived more than 21 months with the multimodal therapy.Methods: A case of high-risk, stage four neuroblastoma in a 20-year-old woman who survived more than 21 months with multimodal therapy is reported. The patient initially received neoadjuvant chemotherapy according to the Turkish Pediatric Oncology Group of Neuroblastoma, along with multiple doses of radiotherapy. After two cycles of induction chemotherapy, she successfully underwent tumor debulking surgery.Results: With the multimodal therapy, patient remains in complete remission state and stable disease of the remaining lesions is observed in this patient.Conclusions: Neuroblastoma is a rare disease in adults and associated with a high number of mortality. Early and accurate diagnosis and multimodality of treatments are important to achieve disease control. Long term follow up is necessary for such patients
Lung Abnormalities in Systemic Sclerosis Patients through Spirometry, Chest X-Ray, and High-Resolution Computed Tomography Scan
Get PDFBackground: Systemic sclerosis (SSc) is a multisystem autoimmune illness with a wide range of clinical symptoms. The pulmonary organ manifestations frequently occur, but the symptoms are non-specific. Radiological examination and pulmonary function tests (spirometry) are needed to detect lung abnormalities in SSc patients. This study aimed to obtain information about the overview of lung abnormalities in SSc patients through spirometry, chest x-ray, and high-resolution computed tomography (HRCT) scan examination.Methods: A descriptive qualitative study was conducted on 75 SSc patients registered in Dr. Hasan Sadikin General Hospital Bandung from January 2019 to December 2020. Data were collected with a total sampling method and presented in proportions and percentages.Results: The majority of subjects were affected by cutaneous 73 (97%), pulmonary 29 (39%), and musculoskeletal 17 (23%) involvement. Spirometry revealed that 43 subjects (57%) had restrictive lung disease, with one false-positive case and two false-negative cases. On a chest x-ray, 45 (60%) of subjects had abnormalities. The majority of subjects were found to have Ground-glass opacities on HRCT scans. Ground-glass opacities were discovered in 46 subjects (82%) and 27 subjects (60%) were identified as having severe fibrosis scores.Conclusion: According to spirometry results and abnormalities on chest x-ray and HRCT scans, the majority of SSc patients have restrictive lung disease
Therapeutic Outcomes of Pediatric Acute Myeloblastic Leukemia Patients at a Tertiary Hospital in Bandung, Indonesia
Get PDFBackground: Acute myeloblastic leukemia (AML) is a subtype of leukemia characterized by myeloid infiltration into the bone marrow, blood, and other tissues. AML ranks 5th malignancy in children and the prognosis is poor. After chemotherapy, the outcomes vary. Therefore, this study aimed to provide further insight into the therapeutic outcomes of pediatric AML patients. Methods: This study was conducted with a cross-sectional descriptive method. The data were obtained from the medical records of children diagnosed with AML at the Department of Child Health of Dr. Hasan Sadikin General Hospital in 2017–2019 with the total sampling method. Data including age at determination, gender, laboratory values including hemoglobin, leukocyte, thrombocyte as well as blast cell count on peripheral blood smear were collected. Also, the bone marrow punctures gathered were clustered based on the French-American-British (FAB) classification. Data were presented in tables.Results: In total, 46 data of AML patients were retrieved, with the age category at first diagnosis was >5–12 years (48%) and predominantly males (63%), children with moderate anemia (41%), leukocytosis (35%), severe thrombocytopenia (46%), and blast cell count ≥20% (83%). AML-M2 was the most common subtype (30.4%). The majority of patients (91%) underwent chemotherapy and most (45%) patients died during chemotherapyConclusion: The outcome of AML therapy among children is mostly poor, and particularly die during chemotherapy. Early detection and follow-up of patients to continue therapy are important aspects to reduce the mortality rate of AML
Hiperkapnia Sebagai Prediktor Mortalitas Pasien COVID-19 di Ruang Rawat Intensif
No full textVirus SARS-CoV-2 menyebabkan penyakit pernapasan akut yang disebut COVID-19 dan menyebabkan pandemi global. Proses aktivasi trombosis intravaskular pada COVID-19 menyebabkan komplikasi trombosis mikrovaskular dan makrovaskular sehingga terjadi peningkatan ruang mati paru dan meningkatkan kadar PaCO2. Hiperkapnia menyebabkan banyak perubahan fisiologis dalam tubuh meliputi sirkulasi paru dan sistemik dan meningkatkan risiko mortalitas pasien ARDS. Penelitian ini bertujuan mengetahui apakah hiperkapnia merupakan prediktor mortalitas pasien COVID-19. Penelitian dilakukan berdasarkan data pasien pada periode Maret 2020–Desember 2021. Penelitian ini adalah penelitian analitik observasional dengan rancangan kohort retrospektif. Data PaCO2 pasien diambil saat hari pertama pasien dirawat di ICU RSUP Dr. Hasan Sadikin dan status mortalitas pasien di hari rawat ke-7 dan 28 hari. Analisis statistik yang digunakan adalah analisis bivariabel simple regression logistic. Hasil analisis statistik diperoleh nilai p< 0,05 dengan OR = 7,07 (CI 2,519–19,850) pada mortalitas hari ke-7, dan nilai p< 0,05 OR 44,33 (CI 9,182–214,062) pada mortalitas hari ke-28. Simpulan penelitian ini menunjukkan bahwa hiperkapnia merupakan prediktor mortalitas hari ke-7 dan ke-28 perawatan pada pasien COVID-19 yang dirawat di ruang rawat intensif isolasi.Hypercapnia as Mortality Predictor in COVID-19 PatientsThe SARS-CoV-2 virus causes COVID-19, an acute respiratory illness that caused a global pandemic. The activation of intravascular thrombosis in COVID-19 results in microvascular and macrovascular thrombosis complications, which increase lung dead space and PaCO2 levels. The hypercapnia condition causes many physiological changes in the body, including pulmonary and systemic circulation. It is known to increase the mortality risk in ARDS patients admitted to the Intensive Care Unit (ICU). This study aimed to determine if hypercapnia was a mortality predictor in COVID-19 patients treated in the isolation intensive care unit at Hasan Sadikin Hospital in Bandung. This observational analytic study used an observational analytic design with a retrospective cohort. The patient's PaCO2 data was collected on the first day of hospitalization in the ICU, and the patient's mortality status was collected on the 7th and 28th days of hospitalization. According to the statistical analysis, hypercapnia was associated with higher mortality, OR 7.07 (CI 2.519–19.850) on the 7th-day mortality and 44.33 (CI 9.182–214.062) on the 28th-day mortality, P value < 0.05. In conclusion, hypercapnia is a mortality predictor on the 7th and 28th days of treatment in COVID-19 patients treated in the isolation intensive care unit. Virus SARS-CoV-2 menyebabkan penyakit pernapasan akut yang disebut COVID-19 dan menyebabkan pandemi global. Proses aktivasi trombosis intravascular pada COVID-19 menyebabkan komplikasi trombosis mikrovaskular dan makrovaskular sehingga terjadi peningkatan ruang mati paru dan meningkatkan kadar PaCO2. Hiperkapnia menyebabkan banyak banyak perubahan fisiologis dalam tubuh, meliputi sirkulasi paru dan sistemik dan diketahui meningkatkan resiko mortalitas pasien ARDS yang di rawat di ICU. Penelitian ini bertujuan untuk mengetahui apakah hiperkapnia sebagai prediktor mortalitas pasien COVID-19 yang dirawat diruang rawat intensif isolasi RSUP Hasan Sadikin Bandung. Penelitian dilakukan berdasarkan data pasien pada periode Maret 2020 – Desember 2021. Penelitian ini adalah penelitian analitik observasional dengan rancangan kohort retrospektif. Data PaCO2 pasien diambil saat hari pertama pasien dirawat di ICU dan status mortalitas pasien di hari rawat ke-7 dan 28 hari. Dari hasil analisis statistik diperoleh nilai P < 0,05 dengan OR = 7,07 (CI 2,519 – 19,850) pada mortalitas hari ke-7, dan nilai P < 0,05 OR 44,33 (CI 9,182 – 214,062) pada mortalitas hari ke-28. Simpulan dari penelitian ini menunjukkan kondisi hiperkapnia merupakan prediktor mortalitas hari ke-7 dan ke-28 perawatan pada pasien COVID-19 yang dirawat di ruang rawat intensif isolasi
Association between 25-Hydroxyvitamin D and Mental-Emotional Status in Children during Their First 1000 Days of Life
Get PDFVitamin D receptors are widely expressed in brain tissue, including in the limbic system that plays a role in children's mental and emotional development. This study aimed to analyze the relationship between 25-(OH)-D level and children's mental-emotional development during their first 1000 days of life. A cross-sectional study was conducted on children aged ≤2 years old in Waled and Sukabumi regions using secondary data from previous cohort investigations entitled "The Role of Vitamin D in Efforts to Reduce Maternal and Infant mortality". The measurement of 25-(OH)-D concentration and assessment of the mental-emotional development were performed using the Ages and Stages Questionnaires: Social-Emotional (ASQ-SE) questionnaire. Other child and maternal characteristics, and several laboratory results, were also obtained. Statistical analyses were performed using the Spearman rank, Pearson correlation test, and multivariate linear regression analysis. A total of ninety-two children were included, and the median vitamin D level of the population was 20.17 ng/mL (IQR 4.43–49.97). The correlation analysis showed that no significant relationship between children's mental-emotional scores and the parameters tested, including the concentration of 25-(OH)-D (correlation coefficient 0.08; p=0.446). There was no relationship between the vitamin D concentration and mental-emotional development. Based on these results, it is concluded that there is no correlation between 25-(OH)-D concentration and children’s mental-emotional development during the first 1000 days of life. However, further investigations are recommended to eliminate various confounding factors
Pili Protein 65.5 kDa of Klebsiella pneumoniae Induced a Decrease in IL-10 in Mice
Get PDFKlebsiella pneumoniae is one of the leading cause of nosocomial infection worldwide with clinical isolates mostly found in Multi-Drug Resistant (MDR) or Extensively Drug-Resistant (XDR). This makes therapeutic options due to this bacteria limited. Several studies have shown that the pili protein of K. pneumoniae with different molecular weights plays a role in the virulence factor, as they are hemagglutinin and adhesin proteins. Pili protein 65.5 kDa of K. pneumoniae can be considered as the antigen candidate for vaccines. This study aimed to determine the immune response based on the IL-10 level as induced by pili protein 65.5 kDa K. pneumoniae. This study was conducted from October 2020 to March 2021 at the Faculty of Mathematics and Natural Sciences and Faculty of Medicine of Jember University. This was true experimental with post-test only controlled group design on 27 male BALB/c mice which divided into 3 groups: K1, K2, and K3. The groups were induced with sterile PBS, pili protein and Freund’s adjuvant, and Freund’s adjuvant only, respectively. Samples were drawn through cardiac puncture, then serum was taken to measure the IL-10 levels using the ELISA method. Hemagglutination test showed a positive result with 1/8 as the highest titer. Results showed that the mean IL-10 levels were 290.92±45.33; 235.05±44.53; 218.54±64,81 for K1, K2, and K3, respectively. One-way ANOVA test results showed a statistical difference between groups (p=0,019). This research shows that pili protein 65.5 kDa K. pneumoniae decreases the IL-10 level. However, when it is provided with the Freund’s Adjuvant, there is no proof of the immunogenicity when compared to the control group
Paraoxonase 1 Activities and Lipid Parameters in Hypertension and Their Association with Chronic Alcoholism
Get PDFObjective: To determine lipid profile, antioxidant vitamin (E and C), and malondialdehyde (MDA) levels, as well as superoxide dismutase (SOD) levels and paraoxonase 1 (PON 1) activities in alcoholic hypertensive patients.Methods: Five hundred subjects were selected for this study consisting of 250 normal healthy individuals and 250 alcoholic hypertensive subjects. Total cholesterol, triglyceride, and HDL levels were measured using the enzymatic method while the LDL and VLDL levels were calculated by Friedwald equation. The MDA level were measured using thiobarbiturate (TBA) and the Vitamin E and C were measured using the enzymatic method. The SOD and PON 1 activities were measured using phenyl acetate as the substrate.Results: Total cholesterol, triglycerides, LDL, VLDL, and MDA levels were found to be significantly high while the HDL and Vitamin E and C levels decreased among the alcoholic hypertensive subjects when compared to the control. Furthermore, significant decreases in SOD and PON 1 activities were also found among the alcoholic hypertensive subjects as compared to control.Conclusion: Alterations in lipid parameters, antioxidant vitamin levels, MDA level, SOD activities, and PON 1 activities are associated with hypertension that may be enhanced by alcohol intake, which may lead to the development cardiovascular disease.
Knowledge towards Thalassemia and Willingness to Screen among Students in Public Senior High School 3 Bandung
Get PDFBackground: Thalassemia carrier screening is a major preventive measure potentially influenced by the level of knowledge, particularly in adolescents. Therefore, this study aimed to analyze the effect of health education on knowledge of thalassemia in adolescents and its association with their willingness to do thalassemia screening.Methods: A cross-sectional study was conducted using data regarding knowledge of thalassemia before and after health education sessions from 229 students at Public Senior High-School 3 Bandung. All participants attended a one-day health education in July 2019. A questionnaire was filled in to measure their knowledge regarding thalassemia before and after the session, including knowledge on etiology and definition, risk of disease, clinical manifestations, treatment, complication, prognosis, and disease prevention. Only data with complete questionnaire responses were included. These responses were scored quantitatively and analyzed for their association with participants’ willingness to screen. Results: Participants were knowledgeable concerning thalassemia before the health education session (median, range: 60.0, 25.0-90.0), and knowledge was increased significantly after the education session (median, range: 80.0, 35.0-100.0) with an increased median difference=19.99 (p-value 0.05), the willingness was slightly associated with improved knowledge regarding the risk of disease (OR: 1.02; 95%CI: 1.00-1.03; p-value <0.005). Conclusion: Health education regarding thalassemia significantly increases general knowledge of thalassemia. However, improving knowledge is not significant in influencing adolescents’ motivation to take the screening tests