Simson Samuel, Soerodjotanojo, Michael Humianto, I. Putu, Pramana Suarjaya, Made Septyana, Parama Adi
Background: Chronic myeloid leukemia (CML) is a slow-growing type of cancer that begins in the bone marrow's blood-forming cells and is caused by a chromosomal mutation that is assumed to develop spontaneously. As CML advances into the rapid or blast phase, it can cause significant pain. This study aimed to describe pain management in the blast crisis (BC) phase of CML. Case presentation: A 48-year-old female diagnosed with CML in the BC phase complained of severe pain in the head, shoulders, back, and tailbone area with a numeric rating scale (NRS) of 9/10. The patient received multimodal analgesic therapy with continuous IV fentanyl at a rate of 0.25 mcg/kg/hour and ketamine at 1.3 mcg/kg/minute for 24 hours. The dosage was gradually increased through titration with a target NRS of 4/10. On the fifth day, we replaced fentanyl with morphine at 0.04 mg/kg/hour and ketamine at 1.3 mcg/kg/minute, and we reduced the titration dose according to the patient’s NRS, and her pain was controlled with NRS 3-4/10 after 7 days of treatment. On the 9th day, she was discharged with oral therapy. Conclusion: Multimodal analgesia has been shown to effectively reduce the intensity of the pain in blast crisis phase.
{"title":"Pain Management in Blast Crisis Phase of Chronic Myeloid Leukemia: A Case Report","authors":"Simson Samuel, Soerodjotanojo, Michael Humianto, I. Putu, Pramana Suarjaya, Made Septyana, Parama Adi","doi":"10.37275/bsm.v8i2.921","DOIUrl":"https://doi.org/10.37275/bsm.v8i2.921","url":null,"abstract":"Background: Chronic myeloid leukemia (CML) is a slow-growing type of cancer that begins in the bone marrow's blood-forming cells and is caused by a chromosomal mutation that is assumed to develop spontaneously. As CML advances into the rapid or blast phase, it can cause significant pain. This study aimed to describe pain management in the blast crisis (BC) phase of CML. \u0000Case presentation: A 48-year-old female diagnosed with CML in the BC phase complained of severe pain in the head, shoulders, back, and tailbone area with a numeric rating scale (NRS) of 9/10. The patient received multimodal analgesic therapy with continuous IV fentanyl at a rate of 0.25 mcg/kg/hour and ketamine at 1.3 mcg/kg/minute for 24 hours. The dosage was gradually increased through titration with a target NRS of 4/10. On the fifth day, we replaced fentanyl with morphine at 0.04 mg/kg/hour and ketamine at 1.3 mcg/kg/minute, and we reduced the titration dose according to the patient’s NRS, and her pain was controlled with NRS 3-4/10 after 7 days of treatment. On the 9th day, she was discharged with oral therapy. \u0000Conclusion: Multimodal analgesia has been shown to effectively reduce the intensity of the pain in blast crisis phase.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"211 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138981262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Establishing a diagnosis of interstitial lung disease (ILD) is very important because the diagnosis of ILD is often missed with other lung diseases. Apart from clinical diagnosis of ILD, other tests are also required, such as a lung biopsy, which can be done using open lung biopsy but has high mortality and morbidity rates. Apart from that, lung biopsy can be done using video-assisted thoracoscopy (VATS) and transbronchial biopsy, but it is relatively more expensive compared to examination bronchoalveolar lavage (BAL), which is another diagnostic approach of ILD. Bronchoalveolar lavage is performed using a flexible fiber bronchoscope (fiberoptic bronchoscopy), which has a lower morbidity and mortality rate.
{"title":"Bronchoalveolar Lavage in Interstitial Lung Disease: A Narrative Literature Review","authors":"Rizki Romadani, Sri Indah Indriani","doi":"10.37275/bsm.v8i2.918","DOIUrl":"https://doi.org/10.37275/bsm.v8i2.918","url":null,"abstract":"Establishing a diagnosis of interstitial lung disease (ILD) is very important because the diagnosis of ILD is often missed with other lung diseases. Apart from clinical diagnosis of ILD, other tests are also required, such as a lung biopsy, which can be done using open lung biopsy but has high mortality and morbidity rates. Apart from that, lung biopsy can be done using video-assisted thoracoscopy (VATS) and transbronchial biopsy, but it is relatively more expensive compared to examination bronchoalveolar lavage (BAL), which is another diagnostic approach of ILD. Bronchoalveolar lavage is performed using a flexible fiber bronchoscope (fiberoptic bronchoscopy), which has a lower morbidity and mortality rate.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Humianto, Marilaeta Cindryani, Tjok Gde, Agung Senapathi
Background: This study focused on perioperative fluid administration in pregnant women undergoing a caesarean section (CS) by comparing liberal and non-liberal fluid administration in a multicentre setting across various Hospitals in the Bali province and its surrounding areas. Methods: Sampling was conducted using a total sampling method. All patients meeting the inclusion criteria were included in this study. A total of 310 samples of pregnant patients undergoing CS surgery in various operating rooms across hospitals in the Bali province and surrounding areas were obtained during the period of January to December 2022. The fluid administration strategy was divided into two types: liberal and non-liberal. Data analysis was performed using the Chi-square test with the correlation test of the contingency coefficient. Results: The results showed that liberal fluid administration significantly increased complications in the operating room for pregnant patients undergoing cesarean section (p<0.001; r=0.305; OR 6.22) but not in the recovery room or postoperative hospital ward. Conclusion: Liberal fluid administration could significantly increase complications in the operating room for pregnant patients undergoing cesarean section but not in the postoperative period.
{"title":"Intraoperative Fluid Management Correlates with Intraoperative Complications in Cesarean Section: A Prospective Clinical Trial","authors":"Michael Humianto, Marilaeta Cindryani, Tjok Gde, Agung Senapathi","doi":"10.37275/bsm.v8i2.923","DOIUrl":"https://doi.org/10.37275/bsm.v8i2.923","url":null,"abstract":"Background: This study focused on perioperative fluid administration in pregnant women undergoing a caesarean section (CS) by comparing liberal and non-liberal fluid administration in a multicentre setting across various Hospitals in the Bali province and its surrounding areas. \u0000Methods: Sampling was conducted using a total sampling method. All patients meeting the inclusion criteria were included in this study. A total of 310 samples of pregnant patients undergoing CS surgery in various operating rooms across hospitals in the Bali province and surrounding areas were obtained during the period of January to December 2022. The fluid administration strategy was divided into two types: liberal and non-liberal. Data analysis was performed using the Chi-square test with the correlation test of the contingency coefficient. \u0000Results: The results showed that liberal fluid administration significantly increased complications in the operating room for pregnant patients undergoing cesarean section (p<0.001; r=0.305; OR 6.22) but not in the recovery room or postoperative hospital ward. \u0000Conclusion: Liberal fluid administration could significantly increase complications in the operating room for pregnant patients undergoing cesarean section but not in the postoperative period.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"18 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Mitral regurgitation (MR) indeed presents challenges during noncardiac surgeries, especially as the severity of MR tends to increase with age and poses a higher risk of perioperative complications. Accurate hemodynamic monitoring becomes crucial in these cases to manage potential complications effectively. However, the standard monitoring in MR conditions during operation, such as TEE, is not always available, but there are other options for invasive monitoring, such as arterial lines, which provide accurate hemodynamic monitoring. Case presentation: A 64-year-old, male, presented with Reponible Lateral Inguinal Hernia with comorbid of severe mitral and tricuspid regurgitation alongside congestive heart failure. The patient was premedicated with fentanyl 25 mcg intravenously, followed by oxygen supplementation with 3 lpm nasal cannula and insertion of the arterial line. Anaesthesia was performed using a lumbar epidural technique, with the insertion of an epidural catheter in the L1-L2 intervertebral space, Reponible Lateral Inguinal Hernia. The local anesthesia agent chosen was plain bupivacaine with a concentration of 0.5% and a volume of 8 ml. The onset of action of epidural anesthesia is achieved within 20 minutes as long as the operation reaches a total blockade as high as T8. The patient is monitored with standard monitors and an artery line during surgery. There were no complaints of shortness of breath, chest heaviness, or chest pain felt by the patient during the operation. Conclusion: Epidural anesthesia technique can provide stable hemodynamics in patients with severe mitral-tricuspid regurgitation and congestive heart failure and hemodynamic monitoring plays an important role postoperatively to prevent further deterioration and maintain stability.
{"title":"The Role of Invasive Hemodynamic Monitoring in Patients with Severe Mitral Regurgitation Undergoing Herniorrhaphy Operation","authors":"Titin Agustin Kapitan, A. Pradhana, C. Sinardja","doi":"10.37275/bsm.v8i2.920","DOIUrl":"https://doi.org/10.37275/bsm.v8i2.920","url":null,"abstract":"Background: Mitral regurgitation (MR) indeed presents challenges during noncardiac surgeries, especially as the severity of MR tends to increase with age and poses a higher risk of perioperative complications. Accurate hemodynamic monitoring becomes crucial in these cases to manage potential complications effectively. However, the standard monitoring in MR conditions during operation, such as TEE, is not always available, but there are other options for invasive monitoring, such as arterial lines, which provide accurate hemodynamic monitoring. \u0000Case presentation: A 64-year-old, male, presented with Reponible Lateral Inguinal Hernia with comorbid of severe mitral and tricuspid regurgitation alongside congestive heart failure. The patient was premedicated with fentanyl 25 mcg intravenously, followed by oxygen supplementation with 3 lpm nasal cannula and insertion of the arterial line. Anaesthesia was performed using a lumbar epidural technique, with the insertion of an epidural catheter in the L1-L2 intervertebral space, Reponible Lateral Inguinal Hernia. The local anesthesia agent chosen was plain bupivacaine with a concentration of 0.5% and a volume of 8 ml. The onset of action of epidural anesthesia is achieved within 20 minutes as long as the operation reaches a total blockade as high as T8. The patient is monitored with standard monitors and an artery line during surgery. There were no complaints of shortness of breath, chest heaviness, or chest pain felt by the patient during the operation. \u0000Conclusion: Epidural anesthesia technique can provide stable hemodynamics in patients with severe mitral-tricuspid regurgitation and congestive heart failure and hemodynamic monitoring plays an important role postoperatively to prevent further deterioration and maintain stability.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"16 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138591418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Stroke is the leading cause of death and the most significant contributor to disabilities worldwide. Predicting the mortality of stroke patients and giving optimal care remain challenges in developing countries like Indonesia. In this study, we aimed to identify factors associated with in-hospital mortality after acute ischemic stroke. Methods: The study conducted a retrospective cohort of cerebral infarct patients administered in 2022 to Gunung Jati General Hospital, West Java, Indonesia. This study included hospitalized patients with a clinical history of stroke confirmed by a CT scan or MRI. The clinical data, radiology, and laboratory tests were collected at admission or within 24 hours after admission. Results: This study involved a total of 92 ischemic stroke patients with a median age of 62. The most prevalent comorbidities were dyslipidemia (93.5%), hypertension (83.7% of patients), and concomitant infection (50%). Patients who experienced in-hospital mortality had a significantly higher number of comorbidities, such as chronic kidney disease, concomitant infection, and atrial fibrillation. Statistically higher neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were also shown in non-survived patients. Ischemic stroke patients with concomitant infection and atrial fibrillation, respectively, had 6.679 (aOR: 6.679, 95% CI 1.802-27.029) and 6.904 times (aOR: 6.904, 95% CI 1.290-36.959) greater to have in-hospital mortality. Conclusion: Concomitant infection and atrial fibrillation were associated with in-hospital mortality in ischemic stroke patients at Gunung Jati General Hospital. The findings indicated the importance of identifying timely management for improving better outcomes.
背景:中风是世界范围内死亡的主要原因，也是造成残疾的最主要原因。预测中风患者的死亡率并提供最佳护理仍然是印度尼西亚等发展中国家面临的挑战。在这项研究中，我们旨在确定与急性缺血性脑卒中后住院死亡率相关的因素。方法:该研究对2022年在印度尼西亚西爪哇省Gunung Jati总医院接受治疗的脑梗死患者进行了回顾性队列研究。本研究纳入了经CT扫描或MRI证实有中风临床病史的住院患者。入院时或入院后24小时内收集临床资料、放射学和实验室检查。结果:本研究共纳入92例缺血性脑卒中患者，中位年龄为62岁。最常见的合并症是血脂异常(93.5%)、高血压(83.7%)和合并感染(50%)。住院死亡率较高的患者有明显的合并症，如慢性肾脏疾病、合并感染和心房颤动。在统计上，非存活患者的中性粒细胞与淋巴细胞的比率和血小板与淋巴细胞的比率也较高。合并感染和房颤的缺血性卒中患者住院死亡率分别是前者的6.679倍(aOR: 6.679, 95% CI 1.802 ~ 27.029)和6.904倍(aOR: 6.904, 95% CI 1.290 ~ 36.959)。结论:古农贾提总医院缺血性脑卒中患者并发感染和房颤与住院死亡率相关。研究结果表明，确定及时管理对于改善更好的结果非常重要。
{"title":"Risk Factors of In-Hospital Mortality of Ischemic Stroke Patients in Gunung Jati General Hospital","authors":"El Alsha Andini, R. Dewangga, Adrialmi","doi":"10.37275/bsm.v8i2.910","DOIUrl":"https://doi.org/10.37275/bsm.v8i2.910","url":null,"abstract":"Background: Stroke is the leading cause of death and the most significant contributor to disabilities worldwide. Predicting the mortality of stroke patients and giving optimal care remain challenges in developing countries like Indonesia. In this study, we aimed to identify factors associated with in-hospital mortality after acute ischemic stroke. \u0000Methods: The study conducted a retrospective cohort of cerebral infarct patients administered in 2022 to Gunung Jati General Hospital, West Java, Indonesia. This study included hospitalized patients with a clinical history of stroke confirmed by a CT scan or MRI. The clinical data, radiology, and laboratory tests were collected at admission or within 24 hours after admission. \u0000Results: This study involved a total of 92 ischemic stroke patients with a median age of 62. The most prevalent comorbidities were dyslipidemia (93.5%), hypertension (83.7% of patients), and concomitant infection (50%). Patients who experienced in-hospital mortality had a significantly higher number of comorbidities, such as chronic kidney disease, concomitant infection, and atrial fibrillation. Statistically higher neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were also shown in non-survived patients. Ischemic stroke patients with concomitant infection and atrial fibrillation, respectively, had 6.679 (aOR: 6.679, 95% CI 1.802-27.029) and 6.904 times (aOR: 6.904, 95% CI 1.290-36.959) greater to have in-hospital mortality. \u0000Conclusion: Concomitant infection and atrial fibrillation were associated with in-hospital mortality in ischemic stroke patients at Gunung Jati General Hospital. The findings indicated the importance of identifying timely management for improving better outcomes. \u0000 ","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"51 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138591712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renaldi, I Made Gede Widnyana, Otniel Adrians Labobar
Background: Acute compartment syndrome is a rare complication of the percutaneous Coronary Intervention (PCI) transradial approach but it is very hand-threatening. Treatment for acute compartment syndrome is emergent fasciotomy of the affected compartments to reduce intracompartmental pressure. Axillary plexus block is an excellent choice of anesthesia technique for elbow, forearm, and hand surgery. Case presentation: An 80-year-old, 60 kg, 168 cm man was consulted to our department with a painful swelling on his right upper arm and hand that began three hours after a primary PCI procedure. Previously, the patient had a history of hypertension and diabetes mellitus. The supporting examination results were notable for anemia (Hemoglobin 7,5 g/dL), thrombocytopenia (78 x103/uL), elevated hemostasis function (International Normalized Ratio 1.43), and high blood sugar (360 mg/dL) from echocardiography results anteroseptal and lateral hypokinetic. Before we did block, the patient was given ketamine 10 mcg IV and fentanyl 25 mcg IV for sedation. Axillary plexus block, as a type of regional anesthesia under ultrasound guidance, is a reliable substitute for general anesthesia in high-risk patients, and we do it with a dose of 20 ml of solution (50 mg (10 ml) isobaric bupivacaine 0.5% + 200 mg lidocaine 2% diluted with 20 ml normal saline). During the surgery, the patient was hemodynamically stable. After the operation, the patient was readmitted to the intensive cardiac care unit (ICCU). Conclusion: Axillary plexus block can be an alternative to general anesthesia in patients who will undergo fasciotomy surgery after percutaneous coronary intervention transradial approach with stable hemodynamics during surgery and well-controlled pain after the surgery.
{"title":"Axillary Plexus Block for Anesthesia Management in Patients with Acute Compartment Syndrome after Primary Percutaneous Coronary Intervention (PCI) Transradial Approach: A Case Report","authors":"Renaldi, I Made Gede Widnyana, Otniel Adrians Labobar","doi":"10.37275/bsm.v8i2.917","DOIUrl":"https://doi.org/10.37275/bsm.v8i2.917","url":null,"abstract":"Background: Acute compartment syndrome is a rare complication of the percutaneous Coronary Intervention (PCI) transradial approach but it is very hand-threatening. Treatment for acute compartment syndrome is emergent fasciotomy of the affected compartments to reduce intracompartmental pressure. Axillary plexus block is an excellent choice of anesthesia technique for elbow, forearm, and hand surgery. \u0000Case presentation: An 80-year-old, 60 kg, 168 cm man was consulted to our department with a painful swelling on his right upper arm and hand that began three hours after a primary PCI procedure. Previously, the patient had a history of hypertension and diabetes mellitus. The supporting examination results were notable for anemia (Hemoglobin 7,5 g/dL), thrombocytopenia (78 x103/uL), elevated hemostasis function (International Normalized Ratio 1.43), and high blood sugar (360 mg/dL) from echocardiography results anteroseptal and lateral hypokinetic. Before we did block, the patient was given ketamine 10 mcg IV and fentanyl 25 mcg IV for sedation. Axillary plexus block, as a type of regional anesthesia under ultrasound guidance, is a reliable substitute for general anesthesia in high-risk patients, and we do it with a dose of 20 ml of solution (50 mg (10 ml) isobaric bupivacaine 0.5% + 200 mg lidocaine 2% diluted with 20 ml normal saline). During the surgery, the patient was hemodynamically stable. After the operation, the patient was readmitted to the intensive cardiac care unit (ICCU). \u0000Conclusion: Axillary plexus block can be an alternative to general anesthesia in patients who will undergo fasciotomy surgery after percutaneous coronary intervention transradial approach with stable hemodynamics during surgery and well-controlled pain after the surgery.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"38 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138593758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Coronary heart disease (CHD), commonly known as coronary artery disease (CAD), is a heart disorder that occurs when the arteries supplying blood to the heart walls experience hardening and narrowing, leading to a reduced supply of oxygen and nutrients to the myocardial tissue due to limited coronary blood flow. The treatment of CHD requires revascularization or reperfusion procedures on the coronary blood vessels responsible for supplying the heart muscle. One recommended therapy is coronary artery bypass grafting (CABG). Patients post-CABG are at risk of experiencing major adverse cardiovascular events (MACE). Methods: This design is a cross-sectional study involving all patients who underwent CABG at Siloam Hospitals in Lippo Village and Kebon Jeruk from January to June 2023. Data analysis using a regression approach aims to evaluate the relationship between various prognostic factors and MACE occurrences, thereby identifying a cross-sectional association between these variables and MACE events. Results: Findings from this cross-sectional study indicate a correlation between overweight and the occurrence of recurrent MACE in patients with a history of CABG (p-value = 0.037). These results suggest that individuals with obesity undergoing CABG have a higher risk of experiencing recurrent MACE in CHD. Conclusion: The prognostic factor for recurrent CHD-related major adverse cardiovascular events (MACE) is body mass index (BMI). Monitoring body mass index (BMI) in CHD patients who have undergone CABG is essential to reduce the risk of recurring MACE in the future.
{"title":"Prognostic Factors for the Occurrence of Recurrent Major Adverse Cardiac Events after Isolated Coronary Arterial Bypass Graft","authors":"Hendyono Lim, Azzahra Maheswari Noersamsjah, Andry Irawan","doi":"10.37275/bsm.v8i2.916","DOIUrl":"https://doi.org/10.37275/bsm.v8i2.916","url":null,"abstract":"Background: Coronary heart disease (CHD), commonly known as coronary artery disease (CAD), is a heart disorder that occurs when the arteries supplying blood to the heart walls experience hardening and narrowing, leading to a reduced supply of oxygen and nutrients to the myocardial tissue due to limited coronary blood flow. The treatment of CHD requires revascularization or reperfusion procedures on the coronary blood vessels responsible for supplying the heart muscle. One recommended therapy is coronary artery bypass grafting (CABG). Patients post-CABG are at risk of experiencing major adverse cardiovascular events (MACE). \u0000Methods: This design is a cross-sectional study involving all patients who underwent CABG at Siloam Hospitals in Lippo Village and Kebon Jeruk from January to June 2023. Data analysis using a regression approach aims to evaluate the relationship between various prognostic factors and MACE occurrences, thereby identifying a cross-sectional association between these variables and MACE events. \u0000Results: Findings from this cross-sectional study indicate a correlation between overweight and the occurrence of recurrent MACE in patients with a history of CABG (p-value = 0.037). These results suggest that individuals with obesity undergoing CABG have a higher risk of experiencing recurrent MACE in CHD. \u0000Conclusion: The prognostic factor for recurrent CHD-related major adverse cardiovascular events (MACE) is body mass index (BMI). Monitoring body mass index (BMI) in CHD patients who have undergone CABG is essential to reduce the risk of recurring MACE in the future.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"58 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138595256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-alcoholic fatty liver disease (NAFLD) is a liver disease which has high prevalence in the society. There is no drug that is considered to be able to effectively treat this disease until today. The treatments has wide range from modifications to diet and exercise. The role of vitamin E in the treatment of NAFLD has been studied in many researches. It has high antioxidant capacity that have the ability to decrease the level of reactive oxygen species (ROS) and prevent oxidative damage that can cause cellular senescence and apoptosis. The antioxidant properties may inhibit the progression into liver damage and may even treat hepatic fibrosis in NAFLD. It also has an anti-inflammatory role that affects various inflammatory cytokines produced in NAFLD. The use of vitamin E in non-alcoholic steatohepatitis without diabetes is advised by recent guidelines from the American Association for Study of Liver Disease (AASLD) and the European Association for the Study of Liver Disease (EASLD). In patients with non-alcoholic steatohepatitis, vitamin E can decrease oxidative stress, inhibit the pathogenesis of the disease, and be used as a therapeutic option. However, new research on the safety and efficacy of vitamin E in treating diabetic non-alcoholic steatohepatitis patients is still deemed insufficient.
{"title":"The Effects of Vitamin E Administration in Non-Alcoholic Fatty Liver Disease","authors":"Tri Handayani, A. Prijanti","doi":"10.37275/bsm.v8i1.909","DOIUrl":"https://doi.org/10.37275/bsm.v8i1.909","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) is a liver disease which has high prevalence in the society. There is no drug that is considered to be able to effectively treat this disease until today. The treatments has wide range from modifications to diet and exercise. The role of vitamin E in the treatment of NAFLD has been studied in many researches. It has high antioxidant capacity that have the ability to decrease the level of reactive oxygen species (ROS) and prevent oxidative damage that can cause cellular senescence and apoptosis. The antioxidant properties may inhibit the progression into liver damage and may even treat hepatic fibrosis in NAFLD. It also has an anti-inflammatory role that affects various inflammatory cytokines produced in NAFLD. The use of vitamin E in non-alcoholic steatohepatitis without diabetes is advised by recent guidelines from the American Association for Study of Liver Disease (AASLD) and the European Association for the Study of Liver Disease (EASLD). In patients with non-alcoholic steatohepatitis, vitamin E can decrease oxidative stress, inhibit the pathogenesis of the disease, and be used as a therapeutic option. However, new research on the safety and efficacy of vitamin E in treating diabetic non-alcoholic steatohepatitis patients is still deemed insufficient.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"18 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138600909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katerine Junaidi, Oea Khairsyaf, Fenty Anggrainy, Deddy Herman
An adequate chest drainage system is the main goal of fluid and air evacuation and restoring negative pressure intrapleural so it can help lung development. The intrapleural is a closed, airtight space filled with a small amount of fluid as a lubricant for lung movement during the breathing process. Accumulation of intrapleural air is known as pneumothorax, and one of the initial management options is the implantation chest tube. Chest tubes, which are connected to a water seal, conventionally show varying results and have shortcomings because they require monitoring and limit patient mobility, so the safety of their use in outpatient settings is questionable. Lungs that are not inflated or have an inflated water seal still show air bubbles even though it has been installed. A chest tube adequate for 48 hours is a condition known as persistent air leak, thus requiring extended usage time from chest tube to the drainage management complex. Use of ambulation management through the use of various tools and equipment devices which can be connected with a chest tube can be an option with the aim of reducing treatment time, lowering funding, increasing comfort and hopefully providing better external results.
{"title":"One-Way Valve as Management of Chest Tube Ambulation in Pneumothorax Cases","authors":"Katerine Junaidi, Oea Khairsyaf, Fenty Anggrainy, Deddy Herman","doi":"10.37275/bsm.v8i2.915","DOIUrl":"https://doi.org/10.37275/bsm.v8i2.915","url":null,"abstract":"An adequate chest drainage system is the main goal of fluid and air evacuation and restoring negative pressure intrapleural so it can help lung development. The intrapleural is a closed, airtight space filled with a small amount of fluid as a lubricant for lung movement during the breathing process. Accumulation of intrapleural air is known as pneumothorax, and one of the initial management options is the implantation chest tube. Chest tubes, which are connected to a water seal, conventionally show varying results and have shortcomings because they require monitoring and limit patient mobility, so the safety of their use in outpatient settings is questionable. Lungs that are not inflated or have an inflated water seal still show air bubbles even though it has been installed. A chest tube adequate for 48 hours is a condition known as persistent air leak, thus requiring extended usage time from chest tube to the drainage management complex. Use of ambulation management through the use of various tools and equipment devices which can be connected with a chest tube can be an option with the aim of reducing treatment time, lowering funding, increasing comfort and hopefully providing better external results.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"129 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138599114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katerine Junaidi, Oea Khairsyaf, Russilawati Russilawati, Deddy Herman
Background: Subcutaneous emphysema often occurs in cases of implanted pneumothorax chest tubes and must always be evaluated. Subcutaneous emphysema is a condition where air or gas is found in the tissue under the skin. Case presentation: A 49-year-old man was treated for sudden shortness of breath that occurred after a violent cough accompanied by pain and heaviness in the chest area 1 day before admission to the hospital. The patient had previously received anti-tuberculosis drug treatment for 6 months based on chest X-ray results in 2022, and the patient had undergone a rapid molecular test (TCM) examination, mycobacterium tuberculosis (Mtb), and obtained Mtb results not detected. Lung auscultation obtains sound intensity breath weakness until it disappears in both lung fields. Palpation of the skin revealed widespread crepitus on the face, neck, upper extremities, back, chest, and abdomen. The range of motion areas of the neck, shoulders, and hands are limited due to pain with movement. Evaluation of the chest tube obtained: the chest tube was installed in the anterior axillary line on the right at the level of the 5th intercostal space with number 10 attached to the chest wall and the chest tube well fixed to the chest wall. The end chest tube has been connected to the WSD bottle, and evaluation of the WSD shows that there are undulations and bubbles. Conclusion: The patient was admitted with spontaneous pneumothorax secondary to tuberculosis and was implanted with a chest tube.
{"title":"Management of Extensive Subcutaneous Emphysema with Blow Hole Infraclavicular Incision and Continuous Suction Installation","authors":"Katerine Junaidi, Oea Khairsyaf, Russilawati Russilawati, Deddy Herman","doi":"10.37275/bsm.v8i1.914","DOIUrl":"https://doi.org/10.37275/bsm.v8i1.914","url":null,"abstract":"Background: Subcutaneous emphysema often occurs in cases of implanted pneumothorax chest tubes and must always be evaluated. Subcutaneous emphysema is a condition where air or gas is found in the tissue under the skin. \u0000Case presentation: A 49-year-old man was treated for sudden shortness of breath that occurred after a violent cough accompanied by pain and heaviness in the chest area 1 day before admission to the hospital. The patient had previously received anti-tuberculosis drug treatment for 6 months based on chest X-ray results in 2022, and the patient had undergone a rapid molecular test (TCM) examination, mycobacterium tuberculosis (Mtb), and obtained Mtb results not detected. Lung auscultation obtains sound intensity breath weakness until it disappears in both lung fields. Palpation of the skin revealed widespread crepitus on the face, neck, upper extremities, back, chest, and abdomen. The range of motion areas of the neck, shoulders, and hands are limited due to pain with movement. Evaluation of the chest tube obtained: the chest tube was installed in the anterior axillary line on the right at the level of the 5th intercostal space with number 10 attached to the chest wall and the chest tube well fixed to the chest wall. The end chest tube has been connected to the WSD bottle, and evaluation of the WSD shows that there are undulations and bubbles. \u0000Conclusion: The patient was admitted with spontaneous pneumothorax secondary to tuberculosis and was implanted with a chest tube.","PeriodicalId":102064,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"66 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138605061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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