Accreditation
SINTA 2Nationally Accredited Journal
Vol. 7 No. 11 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Double Limberg Flap for Stage IV Sacral Decubitus Ulcers with Compression Fracture of the First Vertebra of Lumbar Spine: A Case Report
Views: 769Downloads: 356Background: Decubitus ulcers are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. There are numbers of surgical methods have been devised over a year for treatment of decubitus ulcers. Double Limberg flap is our procedure of choice, which we present here as our experience. Case presentation: The study describe a 29 years old male with chief complaint is unable to move both limbs. One month before admission the patient admitted that he had been hit by the roof of the chicken coop while cleaning it. After the incident, the patient wan unable to move his legs. The patient also admitted that he was unable to control his urination and bowel movements. The patient also complained that there were ulcers in the buttocks that were caused by being in bed for a long time. At Dr. Mohammad Hoesin General Hospital, the patient is planned to undergo posterior stabilization. After the posterior stabilization is carried out, this patient was planned to have the ulcer closure using a Limberg flap. The double limber flap survived completely. Flap necrosis was not seen in this case. The largest defect covered by this flap. There was no recurrence of pressure sores in this patient in the 6 month follow-up period. Conclusion: The Limberg flap is a fast, accurate and reliable alternative surgical technique utilizing local tissue in treating sacral decubitus ulcer. Limberg flap repair is an effective technique with short learning curve, patient comfort, early healing, and least complications and recurrence rates are the advantages of this procedure.
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Comparison of Pain Intensity in Canine Removal Using Closed Coil Spring Niti, Open Coil Spring Niti, Elastomeric Chain Short, Elastomeric Chain Long in Edgewise Standard Fixed Orthodontic Treatment
Views: 650Downloads: 428Background: Every canine is pulled during fixed orthodontic treatment, whether using an elastomeric chain short, elastomeric chain long, closed coil spring, or open coil spring, tends to cause pain for the patient. Which of the four components of the active device is the best in terms of the pain effect felt by the patient. Pain is a symptom that underlies most patients’ rejection of proposed treatment plans. The success of treatment cannot be separated from factors of relief of pain in general, and failure to address these factors may leave patients fearful of returning. This study aimed to compare pain intensity during canine extraction using closed coil spring niTi, open coil spring niTi, elastomeric chain short, and elastomeric chain long in fixed orthodontic treatment standard edgewise.
Methods: This study is a longitudinal experimental research. A total of 16 research subjects participated in this study. The data analysis technique for this research is pain intensity analysis based on the time when the canine tooth is retracted using a tool elastomeric chain short, elastomeric chain long, closed coil spring, open coil spring, using the VAS questionnaire on the 1st, 3rd, and 7th days using non-parametric Kruskal Wallis statistical tests to find out whether there are significant differences between 3 different times on 4 different types of equipment.
Results: There is no difference in intensity pain after canine retraction using closed coil spring, open coil spring, elastomeric chain short, or elastomeric chain long devices in standard edgewise fixed treatment based on VAS on the 1st, 3rd, and 7th days. There is no difference in intensity pain after canine retraction using a closed coil spring appliance in standard edgewise fixed treatment based on VAS on the 1st, 3rd, and 7th days. There are differences in the intensity of pain after retraction of the canine tooth using an elastomeric chain short, elastomeric chain long appliance in standard edgewise fixed treatment based on VAS on the 1st and 3rd days.
Conclusion: There are differences in pain intensity during canine extraction using closed coil spring niTi, open coil spring niTi, elastomeric chain short, and elastomeric chain long in fixed orthodontic treatment standard edgewise.
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The Effect of Oral N-Acetyl Cysteine Administration on Acute Kidney Injury Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia
Views: 3,504Downloads: 615Background: Acute kidney injury (AKI) is a clinical condition characterized by a rapid decline in kidney function that includes structural damage (injury) or malfunction (impairment). AKI is a common complication that occurs in 5-10% of patients due to various underlying etiologies. One of the underlying pathophysiology of AKI is the role of discharge reactive oxygen species (ROS), which causes injury to kidney cells. From various studies, it has been reported that N-acetylcysteine (NAC) has anti-inflammatory and antioxidant effects and has an effect on reducing serum creatinine values.
Methods: This research is an open randomized clinical trial without control involving 30 patients at Dr. Mohammad Hoesin General Hospital, Palembang, who were all given intervention in the form of NAC 1200 mg/day, starting in September – October 2023. This study aimed to determine the role of NAC in reducing serum creatinine values in patients with acute kidney injury at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Data analysis was carried out using SPSS 21 univariate and bivariate.
Results: From the research results, it was found that the average age of patients was 53.9 years, involving 21 males (70%, N=30) and 9 females (30%, N=30). The most common causes were prerenal and then renal (53.3% and 46.7%). The initial serum creatinine level was found to be 2.12± 0.79 mg/dL (n = 30 samples), and after administration of the intervention, the mean serum creatinine level was 1.28± 0.63 mg/dL (n = 30 samples). By using a paired t-test, there was a decrease in serum creatinine levels significant (p=0,012).
Conclusion: NAC administration to patients with acute kidney injury of pre-renal or post-renal causes has a statistical effect on reducing serum creatinine values in patients with acute kidney injury at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
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The Relationship between Plasma Glutamate Levels and Sleep Quality in HIV Patients
Views: 575Downloads: 395Background: Disturbance sleep quality is often found in sufferers of human immunodeficiency virus (HIV). Disturbed sleep quality can affect immunity, which ultimately can increase patient morbidity and mortality. Impaired sleep quality in HIV sufferers is related to neurotoxicity due to the HIV virus, which damages sleep architecture. HIV infection can cause an increase in brain extracellular glutamate. Elevated glutamate plays a role in neuronal and glial damage and death. This study aimed to assess the relationship between plasma glutamate levels and sleep quality in HIV sufferers.
Methods: The research uses a cross-sectional design. The samples were HIV sufferers in a polyclinic voluntary counseling test (VCT) internal medicine of Dr. M. Djamil General Hospital Padang, who met the inclusion and exclusion criteria. Samples are selected by consecutive methods. Sleep quality was assessed using a questionnaire called the Pittsburgh sleep quality index (PSQI). Plasma glutamate levels were measured using the ELISA method. Statistical analysis using SPSS with a p-value <0.05 was considered statistically significant.
Results: The research sample consisted of 82 people. The median plasma glutamate level was 16.39 µg/mL. Impaired sleep quality was found in 45 (54.9%) HIV sufferers. There was no significant relationship between plasma glutamate levels (p= 0.506), age (p=0.795), gender (p=0.547), education (p=0.358), occupation (p=0.255), disease duration (p=0.348), stage (p=0.309) and type of ARV therapy (p=0.791) with sleep quality in HIV sufferers. From this research, a significant relationship was found between sleep quality, body mass index (BMI) (p= 0.015), and marital status (p= 0.039).
Conclusion: There is no relationship between plasma glutamate levels and sleep quality in HIV sufferers. There are other factors that influence sleep quality, namely BMI and marital status.
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Direct Closure Technique for Superior Palpebra Defect in Sebaceous Gland Carcinoma Palpebra
Views: 620Downloads: 375Background: Sebaceous Gland Carcinoma (SGC) palpebra is a malignancy tumor on the palpebra that originates from the sebaceous gland. These tumors can spread peripherally through intraepithelial or pagetoid growths. The main management is surgery, and the defect reconstruction is performed according to the size and area of the defect.
Case presentation: A 53-year-old female patient came with a mass on the upper eyelid of the right eye for 1 year, which progressively grew in size and stuck to the eyelid, with no bleeding and no pain. The history of treatment has not provided an adequate response for the last 1 year. Visual acuity was 6/12 in both eyes, and a mass was found approximately 8x8 mm in size, nodular, fixed, and accompanied by madarosis. The histopathological examination showed a palpebral sebaceous gland carcinoma. There was no enlargement of submandibular or parotid lymph nodes. The patient underwent a wide excision of the upper eyelid lesion. Then, the defect was reconstructed by direct closure technique. The patient has been controlled 4 weeks of follow‑up. The functional and cosmetic outcomes were satisfied.
Conclusion: After a month of follow-up, no recurrence occurred. Reconstruction with direct closure technique has good results in terms of anatomy, function, and cosmetics.
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Comparison of the Effectiveness of Lyophilized Amniotic Membranes in the Partial Thickness Wound Healing Process in Mus musculus
Views: 558Downloads: 300Background: Currently, tulle or gentamicin ointment is generally used to prevent wound infections in wound care. Human amniotic membrane has been used in medical fields such as wound care. So far, there is no comparative evidence of the effectiveness of each ingredient. This study aimed to compare the effectiveness of lyophilized amniotic membrane, tulle, and 0.1% gentamicin ointment in the wound healing process. partial thickness on Mus musculus clinically and histologically.
Methods: This type of research is experimental with a post-test-only control group design. There were 24 rats divided into each group. This research was conducted at the anatomical pathology laboratory, Faculty of Medicine, Universitas Andalas, and INA lab in July - September 2023 using rats (Mus musculus), which were divided into 3 treatment groups and one control group.
Results: Clinically, lyophilized amniotic membrane, 0.1% gentamicin ointment, and tulle provided better results than controls regarding erythema variables. Histologically, the results showed that the lyophilized amniotic membrane group had the thinnest epidermis and dermis, as well as better histological scores for granulation, fibroblasts, and collagen than the 0.1% gentamicin ointment, tulle, and control groups. In this study, significant differences in effectiveness were found in terms of erythema, skin thickness, granulation, fibroblast, and collagen histological scores, with better results in the lyophilized amniotic membrane group.
Conclusion: Clinically, lyophilized amniotic membrane, tulle, and 0.1% gentamicin ointment were more effective than controls for wound treatment due to faster reduction in erythema. However, histologically, the lyophilized amniotic membrane was proven to be more effective than tulle, 0.1% gentamicin ointment, and control in terms of epidermis and dermis thickness, granulation level, fibroblasts, and collagen.
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Papillary Renal Cell Carcinoma Type 1 Accompanied by Hemorrhagic Anemia: A Case Report
Views: 795Downloads: 359Background: Kidney cancer or renal cell carcinoma (RCC) accounts for 5% and 3% of all adult malignancies in men and women, respectively, thus representing the 7th most common cancer in men, and the 10th most common cancer in women. The incidence of kidney cancer in the last two decades has shown an increase, but in recent years the death rate due to kidney cancer has decreased because it is increasing.
Case Presentation: A 27 year old male patient came with complaints of bloody urination. Patients also complain of body weakness. Every time they are active, the weakness decreases if the patient rests. The patient was stated to be suffering from anemia and a left kidney tumor. There was bilateral antebrachial pitting edema. There was bilateral pretibial edema. Cytological examination revealed papillary renal cell carcinoma type 1.
Conclusion: Papillary cell carcinoma type 1 is a kidney tumor that has a good prognosis, especially if found at an early stage. The classic symptoms of type 1 pRCC are anemia, hematuria and kidney swelling.
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Renal Amyloidosis: A Narrative Literature Review
Views: 776Downloads: 870Amyloidosis is a disorder in which soluble proteins aggregate and are deposited extracellularly in tissues as insoluble fibrils, causing progressive organ dysfunction. Amyloid fibril formation begins with misfolding of amyloidogenic precursor proteins. The fibrils have a characteristic appearance by electron microscopy and produce double refraction under polarized light when stained with Congo red dye. Classification of amyloidosis is based on the precursor proteins that form amyloid fibrils and the distribution of amyloid deposition both systemically and locally. The main form of systemic amyloidosis; AL amyloid, AA amyloidosis, ATTR amyloid. The kidney is the organ most frequently involved in systemic amyloidosis. Systemic amyloidosis may originate from anomalous proteins, such as immunoglobulin light chains or serum amyloid protein in chronic inflammation or may arise from hereditary disorders. The clinical manifestations of renal amyloidosis vary with the type of amyloid protein and the location and extent of amyloid deposition. Treatment of amyloidosis should be a two-part process; managing symptoms and reducing or stabilizing amyloid protein. Treatment of amyloidosis is focused on reducing the production of amyloidogenic proteins and inhibiting their aggregation.
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Diurnal Variation of Blood Pressure and Arterial Stiffness in Chronic Kidney Disease
Views: 613Downloads: 561Hypertension and chronic kidney disease (CKD) are interrelated public health problems throughout the world. Hypertension accompanied by CKD is mostly difficult to control. Difficulty in controlling blood pressure (BP) is known from changes in the diurnal variation of BP over 24 hours in CKD patients with a pattern of non-dipping and reverse dipping at night and an increase in pulse pressure due to arterial stiffness that occurs in CKD, resulting in a high incidence of nocturnal hypertension and masked hypertension. Nocturnal hypertension in CKD has a significant prognostic risk of increased risk of cardiovascular disease and cause of death. Therefore, guidelines for the management of hypertension strongly recommend that patients with hypertension have blood pressure well controlled at all times, especially to improve hypertension control at night in CKD patients.
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Clinical Insights into Internuclear Ophthalmoplegia: A Case Report
Views: 1,249Downloads: 458Background: Internuclear ophthalmoplegia (INO) is a rare neuro-ophthalmological disorder characterized by impaired horizontal eye movement coordination due to lesion in the medial longitudinal fasciculus. INO commonly results from demyelinating diseases, vascular lesions, or structural brain abnormalities.
Case presentation: A 60-year-old male patient presented with diplopia for the past 4 days. He had history of hypertension and diabetes mellitus and “mild” stroke for past years. Clinical examination revealed normal primary gaze, limited medial movement of the left eye, and diplopia in all gaze positions. Hess screen examination demonstrated underaction of the left medial rectus muscle and overaction of the right lateral rectus muscle. The laboratory results an elevated blood sugar level. Brain CT scan revealed multiple infarcts in the right parietal and cerebellar lobes and left parieto-occipital lobe, with evidence of brain atrophy. The patient was diagnosed with INO. Management involved addressing the underlying systemic diseases, namely diabetes and hypertension, in collaboration with internist and neurologist. The patient also received citicoline therapy and underwent regular follow-up. In the third-month follow-up, the patient demonstrated significant improvement, with reduction in diplopia and enhancement in left eye medial movement.
Conclusion: This case report highlights the importance of considering INO in patients presenting with diplopia and a history of vascular risk factors. Timely diagnosis and comprehensive management with regular follow-up is crucial to monitor the progress and enhance the patient's quality of life.
