International Journal of Integrated Health Sciences
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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
Indications and Complications of Orthopedic Hardware Removal in an Indonesian Tertiary Hospital: A Descriptive Study
Get PDFObjective: To acquire clinical data regarding indications of implant removal and complications in orthopedic metal implant removal. Methods: This was a cross-sectional observational descriptive study using patient medical records. The inclusion criterion was all patients who underwent orthopedic metal implant removal during 2018-2020 while the exclusion criterion was unintentional implant removal due to subsequent injury or loosening. Data regarding anatomic regions, indications, and complications were collected and presented in tables.Results: In 112 patients participated in this study consisting of 75 (67%) men and 37 (33%) women, the implants were mainly located in thigh, lower leg, and ankle (53% combined). The most common indication for metal implant removal was conversion (31%), followed by infection (25%) and patient's request (20%). The only complication observed in orthopedic metal implant removal in this study was disturbed wound healing in a small percentage of the patients (16%). Most patients (84%) did not experience any complication due to metal implant removal.Conclusions: Indications for metal implant removal may vary, with or without symptoms. Disturbed wound healing is a complication observed in metal implant removal. Despite the advantages of removal, further analysis and guidelines are needed to avoid unnecessary hardware removal considering the risk of complications
Mental Health Overview in Bullying Victim Students: A Descriptive Analysis
Get PDFObjective: To identify the impact of bullying behavior on the mental health of students who are victims of bullying.Methods: This was a cross-sectional descriptive quantitative study on 105 students in Medan Perjuangan district from November - December 2021. Sampling was performed using accidental sampling techniques on students living in the study area. A questionnaire was used to collect data and analysis was performed using univariate analysis with an estimated value of 95% confidence of 5%. Results: More than 70% of respondents received some forms of bullying such as body shaming, intelligence discrimination, and parental work shaming, discrimination based on their religion and beliefs, and abusive words. More than 60% of students were also discriminated, ridicule, and subjected to physical violence. About 50% of respondents were also bullied based on their financial, racial/ethnicity, and skin color traits and received physical abused.Conclusion: There is a link between mental health conditions and bullying behavior in students who are victims of bullying
Culprit-Only Versus Complete Revascularization in STEMI Multi-Vessel Disease: A Case Report
Get PDFObjective: To revisit data and highlight management of STEMI multi-vessel disease and explore culprit-only versus multi-vessel PCI and optimal timing to achieve complete revascularization.Methods: A 67 years old male with chest pain at rest 2 hours before admission with a history of smoking one pack of cigarette every day, was presented to the hospital. Physical examination was within normal limit with normal hemodynamically; however, elevated cardiac troponin was identified. Electrocardiogram showed STEMI anteroseptal wall with ischemic inferior wall, leading toSTEMI anteroseptal wall, Killip I diagnosis. Primary PCI was performed and multi-vessel disease was found. A complete revascularization single-staged procedure was performed due to his persistent chest pain. PCI of these coronary stenoses is beneficial to reduce risk of cardiac death and recurrent infarction. However, some issues related to PCI of non-culprit coronary arteries lesion and optimal timing to do complete revascularization is still a dilemma. Results: Related to data from some trials, e.g PRAMI, CvLPRIT, DANAM-3-PRIMULTI, COMPARE-ACUTE, COMPLETE, and some meta-analyses, showed benefit and safety of routine PCI of non-culprit lesions as a preventive strategy to reduce morbidity and mortality. Data showed reduce future morbidity and mortality in this setting. Meanwhile, the optimal timing of complete revascularization is still a matter of debate, although some data showed benefit of index procedural PCI.Conclusion: PCI of non-culprit lesions of myocardial infarction is consistently beneficial over culprit-only revascularization in patients with STEMI multi-vessel disease, despite the debate on the optimum timing for complete revascularization in this setting
Effects of Low-level Laser Therapy on Fibroblast Density in Achilles Tendon Rupture Healing
Get PDFObjective: To investigate the effect of low-level laser therapy (LLLT) on fibroblast proliferation as a part of the tendon healing cascade. Methods: This was an unpaired comparative experimental animal laboratory study with one control groups and two experimental groups, each consisted of 10 Sprague Dawley rats. The experimental groups 1 and 2 were given infrared irradiation for 15 minutes and 30 minutes per day, respectively, after having their achilles tendon partially cut. Histological assessment was carried out to assess the fibroblast density in healing site after three weeks on intervention. Results: The median values of fibroblast density in group 1, group 2, and control group were 1, 2, and 1, respectively, with a p-value of 0.014. No significant difference (p = 0.123) was identified on Mann-Whitney test between the fibroblast density of group 1 and group 2. The same was also true forgroup 1 and control group (p = 0.315). A significant difference was found between group 2 and control group (p = 0.005). Conclusions: A regime of LLLT irradiation of 30 min/day for two weeks (1080 J cm-2) improves the fibroblast proliferation amidst tendon healing in a partially injured achilles tendon in a rat model, which is not seen in the regime with a 15 min/day duration. This emphasizes the significance of irradiation time to improve tendon healing, despite the deficient understanding of the mechanism
Glioblastoma following Hemorrhagic Stroke: A Case Report
Get PDFObjective: To report a glioblastoma (GBM) case preceded by a hemorrhagic stroke.Methods: This case reported a 53-year-old male presenting at at Murni Teguh Memorial Hospital, Medan, Indonesia, with a chief complaint of an altered mental state. The condition had been worsened for two weeks. On anamnesis, he was identified to have experienced intracerebral hemorrhage in January 2020. A follow-up head computed tomography scan was conducted in September 2020, showing a normal condition of the brain. Other oncogenic risk factors were not found. Due to convulsion in October 2020, the patient underwent a magnetic resonance imaging examination showing a cystic right temporoparietooccipital lesion and cerebral edema. Craniotomy tumor removal surgery was performed while the tumor was further examined for histopathological findings. The tumor was diagnosed as glioblastoma with microvascular proliferation and palisading necrosis.Results: There was some associations between hemorrhagic stroke and glioblastoma development.Conclusion: GBM preceded by hemorrhagic stroke is a rare case that can be diagnosed thoroughly by complete clinical and adjunct examinations
Review on Acute Cardio-Cerebral Infarction: a Case Report
Get PDFObjective: To describe a case of a Cardio-Cerebral Infarction (CCI) male patient presented with a history of chest pain recognized using electrocardiography, brain computed tomography, and Percutaneous Coronary Intervention (PCI).Methods: A 69 years old man came with history of chest pain since 13 hours before to the emergency room. Electrocardiography, brain computed tomography, and PCI were performed, leading to the diagnosis of CCI.Results: The electrocardiography showed ST Elevation in Antero-lateral, atrial fibrillation and left-sided hemipharesis, which occurred on the second day. Brain computed tomography demonstrated acute infarct stroke, while the Percutaneous Coronary Intervention (PCI) showed one vessel disease with severe stenosis in LAD and implanted stent in proximal-mid LAD. Therapy prescribed was providing antiplatelet and anticoagulation.Discussion: Acute Myocardial Infarction (AMI) and Acute Infarct Stroke (AIS) have a narrow therapeutic time-window and a delayed intervention may results in morbidity and death. Antiplatelet and anticoagulant used in PCI for AMI increase the risk for hemorrhagic, and AIS with thrombolytic increase the risk of cardiac wall rupture in AMI. Direct Oral Anticoagulant (DOAC) treatment should reduce ischaemia and lower bleeding. The optimal time point to start anticoagulant treatment might be between 4-14 days after the onset of stroke. Duration of post-PCI triple therapy should be minimized depending on bleeding and risks of ischemia
Correlation between Serum Interleukin-6 Level and Modified Rodnan Skin Score in Systemic Sclerosis Patients
Get PDFObjective: To determine the correlation between serum levels of IL-6 and MRSS in systemic sclerosis patients.Methods: This was a crossectional observational study on patients with SSc visiting the Rheumatology Clinic of Dr. Hasan Sadikin General Hospital Bandung, Indonesia from January 2019 to December 2020. Registered SSc patients, with validated MMRS by a rheumatologist, and available biological materials for IL-6 measurement were included. Patients with other autoimmune diseases, acute infection, diabetes mellitus, and obesity were excluded from this studyResults: Of the 51 SSc patients, 42 patients met the inclusion criteria. Women comprised the majority of these patients (95.2%), while patients’ mean age was 43±12 years. The mean duration of disease was 20 months, with diffuse SSc (78.6%) as the most frequent type. Bivariate analysis showed that IL-6 was positively correlated with MRSS (100-scale) with r=0.397 and p=0.005.Conclusion: There is a medium positive correlation between MRSS and interleukin-6 serum among systemic sclerosis patients visiting Dr. Hasan Sadikin General Hospital Bandung, Indonesia.
Infective Endocarditis with Multiple Valvar Vegetation in Uncorrected Tetralogy Fallot: A Case Report of Rare Condition
Get PDFObjective: To describe a case of an adult patient with uncorrected Tetralogy of Fallot (TOF) who suffered from Infective Endocarditis (IE) that involved the tricuspid and aortic valves.Methods: On October 2019, a-twenty-year-old male with uncorrected TOF was admitted to the emergency department of Dr. Hasan Sadikin General Hospital with a chief complaint of fever. The echocardiography showed the presence of vegetation on the tricuspid valve and aortic valve. The patient was given empirical antibiotics therapy for IE treatment. The serial blood cultures did not yield any organism growth and the transthoracic echocardiography evaluation showed healed vegetation after 21 days of antibiotics treatment.Results: A high turbulence in small VSD and valvular stenosis, as found in TOF, can injure the endocardial surface. While bacterial adherence to the injured endocardial surface can cause IE, no specific criteria available for diagnosing IE in congenital heart disease (CHD) patients compared to other population. In CHD patients, it is necessary to consider the diagnosis of IE presenting with signs of infection or fever. Our patient was known to have uncorrected TOF and was admitted to the hospital with a chief complaint of fever. The uncorrected TOF was complicated by an unusual form of aggressive vegetation involving multiple valves.Conclusion: The incidence of IE in uncorrected TOF is around 4%. Patient is advised to receive a corrective surgery for the cardiac anomaly. Surgical repair of CHD with no residual lesion reduces the risk of IE
Hook effect and serum KL-6 in Patients with Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)
Get PDFObjective To determine whether serum KL-6 can be used as an alternative diagnostic tool for Systemic Sclerosis-associated ILD (SSc-ILD).Method This was a cross-sectional study with compatibility analysis of SSc patients visiting the rheumatology clinic of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia in 2019-2020. Inclusion criteria were aged 18-60 years, diagnosed with SSc, restrictive spirometry results followed by HRCT thorax, having stored biological materials (397.5 unit/mL was declared as ILD. The compatibility analysis was performed using the Cohen’s Kappa test.Results: Thirty-eight subjects, mostly women (94.7%), with mean age of 39 years participated in this study. Most of the subjects suffered from diffuse systemic sclerosis subtypes (57.9%). Subjects had received cyclophosphamide (10.5%), MMF (2.6%), and other medications. Almost all subjects (97.4%) demonstrated ILD features on HRCT thorax. The median serum KL-6 level was 53.22 Units/mL, which was much lower than the findings in other studies, but the hook effect could not be proven. The Kappa coefficient was found to be 0.003 with a p-value of 0.811.Conclusion There is no compatibility between serum KL-6 level and ILD features based on HRCT thorax in SSc-ILD. The presence of hook effect needs more attention