Pub Date : 2023-05-09DOI: 10.3889/oamjms.2023.11596
M. N. Zhannat, B. A. Akmaral, O. Barmenbaeva, Maira Zhantleu Dauren, Zh. Yensegenova Zoya, S. Marzhan, R. S. Daniyar, T. Saltanat, I. T. Nadezhda, U. M. Aigul, Igor Spiroski, A. Z. Dauren
Heart remodeling processes in the development of chronic heart failure (CHF) play a key role in systemic damage to organs and systems. With worsening of CHF, the linear velocities of the liver blood flow (bf) decrease, the diameters of both the common hepatic artery and the portal vein increase. Changes in arterial bf in patients with CHF had a multidirectional character from group to group, narrowing of the lumen of the vessel at the initial stages of the disease and its progressive expansion to functional class IV, fully reflect changes in central hemodynamics, and are explained by the structure of the vessel and its lability in relation to neurohumoral influences characteristic of the development of CHF.
{"title":"Hepatic Hemodynamics in Chronic Heart Failure of Ischemic Genesis","authors":"M. N. Zhannat, B. A. Akmaral, O. Barmenbaeva, Maira Zhantleu Dauren, Zh. Yensegenova Zoya, S. Marzhan, R. S. Daniyar, T. Saltanat, I. T. Nadezhda, U. M. Aigul, Igor Spiroski, A. Z. Dauren","doi":"10.3889/oamjms.2023.11596","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11596","url":null,"abstract":"Heart remodeling processes in the development of chronic heart failure (CHF) play a key role in systemic damage to organs and systems. With worsening of CHF, the linear velocities of the liver blood flow (bf) decrease, the diameters of both the common hepatic artery and the portal vein increase. Changes in arterial bf in patients with CHF had a multidirectional character from group to group, narrowing of the lumen of the vessel at the initial stages of the disease and its progressive expansion to functional class IV, fully reflect changes in central hemodynamics, and are explained by the structure of the vessel and its lability in relation to neurohumoral influences characteristic of the development of CHF.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47865618","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}
Pub Date : 2023-05-06DOI: 10.3889/oamjms.2023.11649
A. Lychagin, V. Cherepanov, A. Garkavi, M. Lipina, I. Lisitzky, A. Korkunov, A. Zarov, A. Gritsyuk, M. Elizarov, G. Prah, Vyazankin Ivan
AIM: The objectives of this study were to perform a systematic literature review based on studies that compare unilateral and bilateral pedicle screw fixation (PSF) in lumbosacral spine fusion to provide recommendations for the treatment of degenerative diseases of the spine, to identify studies with a more complete evidence base, and to identify possible limitations in available literature sources that require further research. METHODS: A literature search was conducted in PubMed, Embase, and the Cochrane Library to identify studies that compare unilateral versus bilateral PSF versus interbody implant placement used the treatment of degenerative diseases of the lumbosacral spine. The study included meta-analyses that met the inclusion criteria. The quality of meta-analyses was evaluated with a measurement tool to assess systematic reviews (AMSTAR) score and the most relevant meta-analysis was determined by applying the Jadad algorithm. RESULTS: Twelve studies fulfilled the eligibility criteria and were included in the study. The results of AMSTAR score ranged from 6 to 9, based on the results, four meta-analysis can be assigned to “middle” category and remained 8 to “upper” category. According to the results obtained, there was no significant difference between unilateral and bilateral PSF; however, unilateral fixation had advantages in the duration of surgical treatment and intraoperative blood loss. СONCLUSION: According to this systematic review, unilateral PSF is an effective fixation method in the formation of lumbosacral spine fusion and has advantages in reducing the duration of surgical treatment and intraoperative blood loss compared to bilateral PSF.
{"title":"Unilateral Pedicle Screw Fixation versus Bilateral Pedicle Screw Fixation for Single-Level Lumbar Degenerative Spine: A Systematic Review of Meta-analyses","authors":"A. Lychagin, V. Cherepanov, A. Garkavi, M. Lipina, I. Lisitzky, A. Korkunov, A. Zarov, A. Gritsyuk, M. Elizarov, G. Prah, Vyazankin Ivan","doi":"10.3889/oamjms.2023.11649","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11649","url":null,"abstract":"AIM: The objectives of this study were to perform a systematic literature review based on studies that compare unilateral and bilateral pedicle screw fixation (PSF) in lumbosacral spine fusion to provide recommendations for the treatment of degenerative diseases of the spine, to identify studies with a more complete evidence base, and to identify possible limitations in available literature sources that require further research. METHODS: A literature search was conducted in PubMed, Embase, and the Cochrane Library to identify studies that compare unilateral versus bilateral PSF versus interbody implant placement used the treatment of degenerative diseases of the lumbosacral spine. The study included meta-analyses that met the inclusion criteria. The quality of meta-analyses was evaluated with a measurement tool to assess systematic reviews (AMSTAR) score and the most relevant meta-analysis was determined by applying the Jadad algorithm. RESULTS: Twelve studies fulfilled the eligibility criteria and were included in the study. The results of AMSTAR score ranged from 6 to 9, based on the results, four meta-analysis can be assigned to “middle” category and remained 8 to “upper” category. According to the results obtained, there was no significant difference between unilateral and bilateral PSF; however, unilateral fixation had advantages in the duration of surgical treatment and intraoperative blood loss. СONCLUSION: According to this systematic review, unilateral PSF is an effective fixation method in the formation of lumbosacral spine fusion and has advantages in reducing the duration of surgical treatment and intraoperative blood loss compared to bilateral PSF.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136012206","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}
Pub Date : 2023-05-05DOI: 10.3889/oamjms.2023.11593
Daniela Lyubenova, A. Dimitrova, Kristin Grigorova-Petrova, Michaela Mitova
BACKGROUND: Autonomous elderly are generally healthy persons in stable clinical status, who do not have any exacerbations, despite of the presence of chronic polymorbidity. Video games for rehabilitation (VGR) could provide more fun and emotion in the routine physiotherapy (PT) sessions and to attract more people stay physically active. AIM: The aim of the study was to evaluate the effect of self-designed 3D camera VGR on mobility and motor abilities in generally healthy older people. MATERIALS AND METHODS: The type of the research is an experimental single-centered study, pre-test and post- test design, conducted at a physical rehabilitation outpatient center. The study is conducted with fifty healthy older people, divided into two groups. The assignment into two groups was according to the preference of the participants to attend video games after routine PT sessions for 7 weeks, 3 times weekly. The experimental group (EG) included 24 women (mean age 76.75 ± 6.89) and the control group consisted of 26 women (mean age 73.69 ± 6.89). The persons were allocated according to their willingness to participate in the study and inclusion (age above 65 years, cooperative, agreeing to participate, and willing to sign a consent form) and exclusion criteria (current exacerbation of a chronic disease, sudden onset of an acute illness, or trauma). The effect on the calf muscle mass, balance, and gait in both groups after the intervention, was evaluated by calf centimetry, Romberg test, functional reach test, 5 times sit-to-stand test, and 10-m walk test. RESULTS: The applied video games positively affected the functional mobility, strength, and endurance of the lower limbs in the EG. Significant differences between the groups were found regarding static standing balance (p < 0.01), functional balance (p < 0.05), and maximum speed gait (p < 0.05) assessed by Mann–Whitney U-test, Wilcoxon, and Student’s t-test. CONCLUSION: The present self-designed video game applied as an additional intervention was more effective than conventional PT alone in mobility, balance, and gait in apparently healthy older people.
{"title":"Effect of Video Games for Rehabilitation on Mobility in Autonomous Older People","authors":"Daniela Lyubenova, A. Dimitrova, Kristin Grigorova-Petrova, Michaela Mitova","doi":"10.3889/oamjms.2023.11593","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11593","url":null,"abstract":"BACKGROUND: Autonomous elderly are generally healthy persons in stable clinical status, who do not have any exacerbations, despite of the presence of chronic polymorbidity. Video games for rehabilitation (VGR) could provide more fun and emotion in the routine physiotherapy (PT) sessions and to attract more people stay physically active.\u0000AIM: The aim of the study was to evaluate the effect of self-designed 3D camera VGR on mobility and motor abilities in generally healthy older people.\u0000MATERIALS AND METHODS: The type of the research is an experimental single-centered study, pre-test and post- test design, conducted at a physical rehabilitation outpatient center. The study is conducted with fifty healthy older people, divided into two groups. The assignment into two groups was according to the preference of the participants to attend video games after routine PT sessions for 7 weeks, 3 times weekly. The experimental group (EG) included 24 women (mean age 76.75 ± 6.89) and the control group consisted of 26 women (mean age 73.69 ± 6.89). The persons were allocated according to their willingness to participate in the study and inclusion (age above 65 years, cooperative, agreeing to participate, and willing to sign a consent form) and exclusion criteria (current exacerbation of a chronic disease, sudden onset of an acute illness, or trauma). The effect on the calf muscle mass, balance, and gait in both groups after the intervention, was evaluated by calf centimetry, Romberg test, functional reach test, 5 times sit-to-stand test, and 10-m walk test.\u0000RESULTS: The applied video games positively affected the functional mobility, strength, and endurance of the lower limbs in the EG. Significant differences between the groups were found regarding static standing balance (p < 0.01), functional balance (p < 0.05), and maximum speed gait (p < 0.05) assessed by Mann–Whitney U-test, Wilcoxon, and Student’s t-test.\u0000CONCLUSION: The present self-designed video game applied as an additional intervention was more effective than conventional PT alone in mobility, balance, and gait in apparently healthy older people.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49270317","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}
Pub Date : 2023-05-04DOI: 10.3889/oamjms.2023.11645
T. Tran, Nguyen Thi Ha Vinh
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Some immunological and genetic factors are believed to be involved in the pathogenesis of SJS/TEN, including T helper 1 and T helper 2 (Th2)-derived cytokines. AIM: This study aims to evaluate the serum levels of Th2-derived cytokines in SJS/TEN, compare to those of erythema multiforme (EM) patients, and the relation between them and the progress of SJS/TEN. METHODS: This was a sectional descriptive study conducted at the National Hospital of Dermatology and Venereology, in Hanoi, Vietnam, from October 2017 to September 2019. 48 SJS/TEN patients, 43 EM patients, and 20 healthy controls (HCs) participated. Serum interleukin (IL)-4, IL-5, and IL-13 levels were measured by using the fluorescence covalent microbead immunosorbent assay (FCMIA) (ProcartaPlex Immunoassay Panels kit, Thermo Fisher Scientific, USA). The Mann-Whitney U test was used to compare the serum IL levels of the two groups. The Wilcoxon tests were used to compare quantitative variables before and after the treatment. Differences were considered to be statistically significant at p < 0.05. RESULTS: 19 SJS patients (39.5%) and 29 TEN patients (60.5%) participated in our study. The mean age was 49.3, range of 19–77 years (47.9% males; 52.1% females). The most common causative drugs were traditional medicine (29.1%), and allopurinol (12.5%). On the day of hospitalization, the serum level of IL-4 in the SJS/TEN group was 3 ± 7.5 pg/mL, statistically significantly higher than that in the HCs group (p < 0.05), but not higher than that in the EM group (p > 0.05); serum levels of IL-5 and IL-13 in the SJS/TEN group were 4.5 ± 9.8 pg/mL and 1.6 ± 0.6 pg/mL, respectively, similar to those in the EM and HCs groups. On the day of re-epithelialization, in SJS/TEN patients, the serum level of IL-5 was 1 ± 2.8 pg/ml, statistically significantly lower than that on the day of hospitalization (3 ± 7.5 pg/mL) with p < 0.05. Regarding serum levels of IL-4 and IL-13, there was no difference between the two- time points. CONCLUSION: The serum concentrations of Th2-derived cytokines (IL-4, IL-5, and IL-13) were not higher in the SJS/TEN group than in the EM group and there was no significant change in the clinical progression of SJS/TEN, except the serum level of IL-5.
{"title":"Serum Concentrations of Thelper2-derived Cytokines in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis","authors":"T. Tran, Nguyen Thi Ha Vinh","doi":"10.3889/oamjms.2023.11645","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11645","url":null,"abstract":"BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Some immunological and genetic factors are believed to be involved in the pathogenesis of SJS/TEN, including T helper 1 and T helper 2 (Th2)-derived cytokines.\u0000AIM: This study aims to evaluate the serum levels of Th2-derived cytokines in SJS/TEN, compare to those of erythema multiforme (EM) patients, and the relation between them and the progress of SJS/TEN.\u0000METHODS: This was a sectional descriptive study conducted at the National Hospital of Dermatology and Venereology, in Hanoi, Vietnam, from October 2017 to September 2019. 48 SJS/TEN patients, 43 EM patients, and 20 healthy controls (HCs) participated. Serum interleukin (IL)-4, IL-5, and IL-13 levels were measured by using the fluorescence covalent microbead immunosorbent assay (FCMIA) (ProcartaPlex Immunoassay Panels kit, Thermo Fisher Scientific, USA). The Mann-Whitney U test was used to compare the serum IL levels of the two groups. The Wilcoxon tests were used to compare quantitative variables before and after the treatment. Differences were considered to be statistically significant at p < 0.05.\u0000RESULTS: 19 SJS patients (39.5%) and 29 TEN patients (60.5%) participated in our study. The mean age was 49.3, range of 19–77 years (47.9% males; 52.1% females). The most common causative drugs were traditional medicine (29.1%), and allopurinol (12.5%). On the day of hospitalization, the serum level of IL-4 in the SJS/TEN group was 3 ± 7.5 pg/mL, statistically significantly higher than that in the HCs group (p < 0.05), but not higher than that in the EM group (p > 0.05); serum levels of IL-5 and IL-13 in the SJS/TEN group were 4.5 ± 9.8 pg/mL and 1.6 ± 0.6 pg/mL, respectively, similar to those in the EM and HCs groups. On the day of re-epithelialization, in SJS/TEN patients, the serum level of IL-5 was 1 ± 2.8 pg/ml, statistically significantly lower than that on the day of hospitalization (3 ± 7.5 pg/mL) with p < 0.05. Regarding serum levels of IL-4 and IL-13, there was no difference between the two- time points.\u0000CONCLUSION: The serum concentrations of Th2-derived cytokines (IL-4, IL-5, and IL-13) were not higher in the SJS/TEN group than in the EM group and there was no significant change in the clinical progression of SJS/TEN, except the serum level of IL-5.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46895519","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}
Pub Date : 2023-05-04DOI: 10.3889/oamjms.2023.11634
Gezim Xhepa, Sokol Isaraj, Gentian Zikaj, Nardi Kola
BACKGROUND: Electrical burns, although constituting a small part of the burns treated in a tertiary hospital, remain a constant burden to the medical staff, due to the nature of the causative agent. PATIENTS AND METHODS: After the Institutional Review Board approval, a retrospective study was performed including all the patients admitted to the Service of Burns and Plastic Surgery, University Hospital Center “Mother Theresa” of Tirana, Albania, from January 2018 to December 2019. Descriptive statistics was used to review the cases for age distribution, body surface area burned, points of entry and exit of the current, acute and late complications, surgical approach, and timing of the latter. RESULTS: Twenty-six patients were admitted during this period, of which 22 suffered a real electrical burn, four of them having only superficial damage from the flash of the electric arc without direct contact with the electrical source. Mean hospital stay was 58.1 days for true electrical burns and 7.5 days for burns from electrical arc. Each patient underwent three surgical interventions in average, of which 20% were fasciotomies, 30% were eschar excision, 35% were reconstructive procedures, and 15% were amputations. Only one fatal outcome was registered. About 36% of the patients were children and the only death was registered among them. Most of cases were due to neglect of safety measures while working with the electrical power, although being professional qualified workers. Acute complications were myoglobinuria, cardiac rhythm disorders, respiratory acidosis, psychomotor agitation, brain concussion and contusion, and acute bleeding. Anemia is the most common late complication. CONCLUSIONS: The prevention is still the best treatment, especially for true electrical burns. Working with the corporate that controls the production and transmission of the electrical power could further reduce the incidence of true electrical burns, while moving to more aggressive surgical approach to such burns might avoid long-term complications and degree of invalidity caused by them.
{"title":"Electrical Burns in Albania and their Treatment: A Review of Cases Treated in 2019–2020","authors":"Gezim Xhepa, Sokol Isaraj, Gentian Zikaj, Nardi Kola","doi":"10.3889/oamjms.2023.11634","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11634","url":null,"abstract":"BACKGROUND: Electrical burns, although constituting a small part of the burns treated in a tertiary hospital, remain a constant burden to the medical staff, due to the nature of the causative agent. PATIENTS AND METHODS: After the Institutional Review Board approval, a retrospective study was performed including all the patients admitted to the Service of Burns and Plastic Surgery, University Hospital Center “Mother Theresa” of Tirana, Albania, from January 2018 to December 2019. Descriptive statistics was used to review the cases for age distribution, body surface area burned, points of entry and exit of the current, acute and late complications, surgical approach, and timing of the latter. RESULTS: Twenty-six patients were admitted during this period, of which 22 suffered a real electrical burn, four of them having only superficial damage from the flash of the electric arc without direct contact with the electrical source. Mean hospital stay was 58.1 days for true electrical burns and 7.5 days for burns from electrical arc. Each patient underwent three surgical interventions in average, of which 20% were fasciotomies, 30% were eschar excision, 35% were reconstructive procedures, and 15% were amputations. Only one fatal outcome was registered. About 36% of the patients were children and the only death was registered among them. Most of cases were due to neglect of safety measures while working with the electrical power, although being professional qualified workers. Acute complications were myoglobinuria, cardiac rhythm disorders, respiratory acidosis, psychomotor agitation, brain concussion and contusion, and acute bleeding. Anemia is the most common late complication. CONCLUSIONS: The prevention is still the best treatment, especially for true electrical burns. Working with the corporate that controls the production and transmission of the electrical power could further reduce the incidence of true electrical burns, while moving to more aggressive surgical approach to such burns might avoid long-term complications and degree of invalidity caused by them.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135011334","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}
Pub Date : 2023-05-04DOI: 10.3889/oamjms.2023.11644
B. Rahardjo, T. Nurseta, Aqua Rossalinda Sinaga
BACKGROUND: Preeclampsia is hypertension in pregnancy which are characterized by high blood pressure, proteinuria that occur after 20 weeks of GA. Preeclampsia remains a massive cause of maternal morbidity and mortality that 50.000 death annually. The cause of preeclampsia is still unclear but there is a possibility caused by immunological processes in micro placenta environment during the early age of pregnancy. It is suggested that cytokines such as tumor necrosis factor (TNF-α) has an important role in the pathogenesis of preeclampsia. Preeclampsia is an extreme feature of the systemic inflammatory response during pregnancy. Systemic inflammation in preeclampsia can cause organ damage and induce sepsis. The pathophysiology is initiated by a high level of pro-inflammatory cytokine that released by peripheral blood mononuclear cell (PBMC). Beside pro-inflammatory cytokine, the marker of sepsis can be shown by procalcitonin (PCT) that produced by PBMC which is activated by TNF-α. AIM: The objective of the study is to evaluate profile maternal plasma levels of TNF-α and PCT and analyze their correlation in normotensive pregnant woman, preeclamptic and preeclampsia with sepsis. METHODS: An observational cross-sectional study. The sample were normotensive, preeclamptic, and preeclamptic with sepsis (n = 18) in Bangil Hospital, Pasuruan. The level of TNF-α and PCT was measured by ELISA. The statistical analysis with SPSS 18.0 with p < 0.05. RESULTS: This study showed level of TNF-α and PCT in preeclamptic with sepsis was significantly higher than control (p < 0.05) and not a significant difference in preeclampsia (p > 0.05). The level of TNF-α and PCT in preeclampsia compared with control was not a significant difference (p > 0.05). This study showed there was no correlation between TNF-α and PCT in patients with preeclampsia with sepsis. CONCLUSION: The plasma level of TNF-α and PCT was statistically different between the control group, preeclampsia and preeclampsia with sepsis. There was no significant difference of TNF-α and PCT plasma level in preeclampsia with sepsis than preeclampsia group. There was no significant correlation between preeclampsia in woman and preeclampsia with sepsis in maternal plasma TNF-α and PCT levels.
{"title":"Profile Tumor Necrosis Factor Alpha and Procalcitonin in Preeclampsia and Preeclampsia with Sepsis","authors":"B. Rahardjo, T. Nurseta, Aqua Rossalinda Sinaga","doi":"10.3889/oamjms.2023.11644","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11644","url":null,"abstract":"BACKGROUND: Preeclampsia is hypertension in pregnancy which are characterized by high blood pressure, proteinuria that occur after 20 weeks of GA. Preeclampsia remains a massive cause of maternal morbidity and mortality that 50.000 death annually. The cause of preeclampsia is still unclear but there is a possibility caused by immunological processes in micro placenta environment during the early age of pregnancy. It is suggested that cytokines such as tumor necrosis factor (TNF-α) has an important role in the pathogenesis of preeclampsia. Preeclampsia is an extreme feature of the systemic inflammatory response during pregnancy. Systemic inflammation in preeclampsia can cause organ damage and induce sepsis. The pathophysiology is initiated by a high level of pro-inflammatory cytokine that released by peripheral blood mononuclear cell (PBMC). Beside pro-inflammatory cytokine, the marker of sepsis can be shown by procalcitonin (PCT) that produced by PBMC which is activated by TNF-α.\u0000AIM: The objective of the study is to evaluate profile maternal plasma levels of TNF-α and PCT and analyze their correlation in normotensive pregnant woman, preeclamptic and preeclampsia with sepsis.\u0000METHODS: An observational cross-sectional study. The sample were normotensive, preeclamptic, and preeclamptic with sepsis (n = 18) in Bangil Hospital, Pasuruan. The level of TNF-α and PCT was measured by ELISA. The statistical analysis with SPSS 18.0 with p < 0.05.\u0000RESULTS: This study showed level of TNF-α and PCT in preeclamptic with sepsis was significantly higher than control (p < 0.05) and not a significant difference in preeclampsia (p > 0.05). The level of TNF-α and PCT in preeclampsia compared with control was not a significant difference (p > 0.05). This study showed there was no correlation between TNF-α and PCT in patients with preeclampsia with sepsis.\u0000CONCLUSION: The plasma level of TNF-α and PCT was statistically different between the control group, preeclampsia and preeclampsia with sepsis. There was no significant difference of TNF-α and PCT plasma level in preeclampsia with sepsis than preeclampsia group. There was no significant correlation between preeclampsia in woman and preeclampsia with sepsis in maternal plasma TNF-α and PCT levels.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44574047","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}
Pub Date : 2023-05-04DOI: 10.3889/oamjms.2023.11613
Evan Savero Widiono, None Martahadinan, Chandra A. Tambunan, Sofa Primatir
BACKGROUND: Colorectal cancer (CRC) is the fourth most common cancer in which the majority of CRCs are diagnosed between the ages of 50 and 70 years. Based on current trends, the incidence of colon and rectal cancers can increase by 124% in people aged 35–49 years and at the age of 20–34 will increase by 28% and 46%. OBJECTIVES: To report a case of a 24-year-old female patient with CRC. CASE REPORT: A 24-year-old female patient came to the Emergency Room at Bendan Hospital, Pekalongan City, with complaints of bleeding since 1 year ago. There are complaints in the past 6 months; the patient’s weight has decreased by up to 20 kg. Rectal toucher examination revealed normal (+) anal sphincter tone, a palpable mass in the anal canal, and was fragile; there were feces and blood in gloves. Abdominal ultrasonography found a solid tumor mass in the rectum area with a volume of 181 cc, suggesting a malignancy of the rectum. During a colonoscopy, a circular, fragile, and easily bleeding tumor was found, approximately 1 cm from the anal verge, and then biopsy was performed. Histopathological examination of the colon biopsy suggests a well-differentiated, rectosigmoid, NOS adenocarcinoma. The patient then underwent surgery using the Miles procedure technique. The patient’s condition after the operation improved, so after a week of treatment, the patient was able to undergo outpatient treatment. CONCLUSION: A complete history, physical examination, and supporting investigation are very useful in early detection of colorectal carcinoma, especially in young patients.
{"title":"A Young Woman with High-Grade Rectosigmoid Adenocarcinoma, no Other Specified, T2n2aM0: A Case Report and Literature Review","authors":"Evan Savero Widiono, None Martahadinan, Chandra A. Tambunan, Sofa Primatir","doi":"10.3889/oamjms.2023.11613","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11613","url":null,"abstract":"BACKGROUND: Colorectal cancer (CRC) is the fourth most common cancer in which the majority of CRCs are diagnosed between the ages of 50 and 70 years. Based on current trends, the incidence of colon and rectal cancers can increase by 124% in people aged 35–49 years and at the age of 20–34 will increase by 28% and 46%. OBJECTIVES: To report a case of a 24-year-old female patient with CRC. CASE REPORT: A 24-year-old female patient came to the Emergency Room at Bendan Hospital, Pekalongan City, with complaints of bleeding since 1 year ago. There are complaints in the past 6 months; the patient’s weight has decreased by up to 20 kg. Rectal toucher examination revealed normal (+) anal sphincter tone, a palpable mass in the anal canal, and was fragile; there were feces and blood in gloves. Abdominal ultrasonography found a solid tumor mass in the rectum area with a volume of 181 cc, suggesting a malignancy of the rectum. During a colonoscopy, a circular, fragile, and easily bleeding tumor was found, approximately 1 cm from the anal verge, and then biopsy was performed. Histopathological examination of the colon biopsy suggests a well-differentiated, rectosigmoid, NOS adenocarcinoma. The patient then underwent surgery using the Miles procedure technique. The patient’s condition after the operation improved, so after a week of treatment, the patient was able to undergo outpatient treatment. CONCLUSION: A complete history, physical examination, and supporting investigation are very useful in early detection of colorectal carcinoma, especially in young patients.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"149 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135011224","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}
Pub Date : 2023-05-03DOI: 10.3889/oamjms.2023.11606
M. Alharbi, Turki Alrashidi, M. Al-Harbi, Essa Al Zahrani, Mohammed H. Alkahlot, Mohammed S Aljaberi
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a multifactorial chronic disease. To avoid long-term and short-term complications, good glycemic control must be achieved. The majority of T2DM patients who require insulin therapy have their doses modified by their physicians; this procedure takes time and may not result in the optimal glycemic control. AIM: This study aims to ascertain whether elderly T2DM patients in Al-Qassim region modify their own insulin regimen and its effect on their glycemic control. METHODS: This cross-sectional study was conducted in Al-Qassim University Medical City and Diabetic Centers in Buraydah, Saudi Arabia. Data were collected using a questionnaire. RESULTS: A total of 384 participants were enrolled with a mean age of 70.2 ± 6.0 (61–94) years, majority (53.6%) of whom were females. About half (50.8%) were not educated and two-third (66.1%) giving insulin injections by themselves. Less than half (40.6%) of the participants changed their insulin dose, out of which 8.3% changed the dose by themselves. The mean hemoglobin A1C (HbA1c) level was 8.8 ± 1.9 with a range of 5.2–17. About 30.5% had recent hypoglycemic attacks, majority (47.9%) of whom had only one episode. Diabetic complications were seen among 127 participants with retinopathy as the most common (43.3%) complication. Hypoglycemic attacks and insulin dose adjusting were not found to be significantly associated (p = 0.476). The last HbA1c level was found to be significantly associated with adjusting insulin dose. CONCLUSION: Self-adjusting insulin dose was found to be rare. Moreover, HbA1c in patients who self-adjust their insulin dose was found to be significantly lower.
{"title":"Assessment of Elderly Type 2 Diabetic Patients who Self-adjust Their Insulin Regimen in Al-Qassim Region","authors":"M. Alharbi, Turki Alrashidi, M. Al-Harbi, Essa Al Zahrani, Mohammed H. Alkahlot, Mohammed S Aljaberi","doi":"10.3889/oamjms.2023.11606","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11606","url":null,"abstract":"BACKGROUND: Type 2 diabetes mellitus (T2DM) is a multifactorial chronic disease. To avoid long-term and short-term complications, good glycemic control must be achieved. The majority of T2DM patients who require insulin therapy have their doses modified by their physicians; this procedure takes time and may not result in the optimal glycemic control.\u0000AIM: This study aims to ascertain whether elderly T2DM patients in Al-Qassim region modify their own insulin regimen and its effect on their glycemic control.\u0000METHODS: This cross-sectional study was conducted in Al-Qassim University Medical City and Diabetic Centers in Buraydah, Saudi Arabia. Data were collected using a questionnaire.\u0000RESULTS: A total of 384 participants were enrolled with a mean age of 70.2 ± 6.0 (61–94) years, majority (53.6%) of whom were females. About half (50.8%) were not educated and two-third (66.1%) giving insulin injections by themselves. Less than half (40.6%) of the participants changed their insulin dose, out of which 8.3% changed the dose by themselves. The mean hemoglobin A1C (HbA1c) level was 8.8 ± 1.9 with a range of 5.2–17. About 30.5% had recent hypoglycemic attacks, majority (47.9%) of whom had only one episode. Diabetic complications were seen among 127 participants with retinopathy as the most common (43.3%) complication. Hypoglycemic attacks and insulin dose adjusting were not found to be significantly associated (p = 0.476). The last HbA1c level was found to be significantly associated with adjusting insulin dose.\u0000CONCLUSION: Self-adjusting insulin dose was found to be rare. Moreover, HbA1c in patients who self-adjust their insulin dose was found to be significantly lower.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47765030","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}
Pub Date : 2023-04-28DOI: 10.3889/oamjms.2023.11608
Dewi Yulianti Bisri, Tatang Bisri
BACKGROUND: Despite the safe nature of the procedure, cesarean section (CS) is still associated with higher maternal mortality and morbidity rates. CS can be performed under spinal, epidural, combined spinal and epidural, or general anesthesia. The choice of anesthesia for CS is still a matter of debate due to its side effects on mothers and neonates. Success in the selection of anesthesia in CS is seen in maternal and neonatal outcomes, where the Apgar score is used for assessing neonates in the first and fifth minutes. AIM: This study aimed to determine the effect of general anesthesia in cesarean section as measured by Apgar score. SUBJECT AND METHODS: This was a cross-sectional analytical retrospective study on a total sample of 7,131 patients who underwent elective cesarean section under general anesthesia during 18 years (July 2004–June 2022) at Melinda Women Hospital Bandung Indonesia. In this study, data from medical records were used to analyze neonatal and maternal outcomes. RESULTS: Of the 7,131 CS under general anesthesia cases, no maternal death or difficult ventilation was found; however, the incidence of postoperative nausea and vomiting (PONV) (15), difficult intubation (6), hypotension (5), and need for blood transfusion (5), and postoperative analgesia (all cases) were observed in the mothers. In neonates, neonatal death caused by IUFD and severe congenital disease (3), and a mean neonatal Apgar score of 9 and 10 at 1 and 5 min were identified. CONCLUSION: No low Apgar score is found as the effect of general anesthesia in cesarean section.
{"title":"Elective Cesarean Section under General Anesthesia Experience in more than 5,000 Patients at Melinda Women Hospital Bandung-Indonesia","authors":"Dewi Yulianti Bisri, Tatang Bisri","doi":"10.3889/oamjms.2023.11608","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11608","url":null,"abstract":"BACKGROUND: Despite the safe nature of the procedure, cesarean section (CS) is still associated with higher maternal mortality and morbidity rates. CS can be performed under spinal, epidural, combined spinal and epidural, or general anesthesia. The choice of anesthesia for CS is still a matter of debate due to its side effects on mothers and neonates. Success in the selection of anesthesia in CS is seen in maternal and neonatal outcomes, where the Apgar score is used for assessing neonates in the first and fifth minutes. AIM: This study aimed to determine the effect of general anesthesia in cesarean section as measured by Apgar score. SUBJECT AND METHODS: This was a cross-sectional analytical retrospective study on a total sample of 7,131 patients who underwent elective cesarean section under general anesthesia during 18 years (July 2004–June 2022) at Melinda Women Hospital Bandung Indonesia. In this study, data from medical records were used to analyze neonatal and maternal outcomes. RESULTS: Of the 7,131 CS under general anesthesia cases, no maternal death or difficult ventilation was found; however, the incidence of postoperative nausea and vomiting (PONV) (15), difficult intubation (6), hypotension (5), and need for blood transfusion (5), and postoperative analgesia (all cases) were observed in the mothers. In neonates, neonatal death caused by IUFD and severe congenital disease (3), and a mean neonatal Apgar score of 9 and 10 at 1 and 5 min were identified. CONCLUSION: No low Apgar score is found as the effect of general anesthesia in cesarean section.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136085096","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}
Pub Date : 2023-04-23DOI: 10.3889/oamjms.2023.11578
Linda Silvana Sari, Titi Prambudi Karuniawaty, P. A. Wiguna
BACKGROUND: Coronavirus disease 2019 (COVID-19) is atypical pneumonia that has spread since December 2019 and named as severe acute respiratory syndrome coronavirus 2. AIM: This study aimed to understand the characteristics of pediatric patients with COVID-19 from the aspect of clinical picture, anthropometric status, and laboratory and radiology findings in Mataram University Hospital. MATERIALS AND METHODS: This qualitative study with descriptive approach. A total of 149 subjects were collected based on the purposive sampling. RESULTS: This study was dominated by female gender (59.1%), age under 12 months old (81.9%), normal body height per age 113 subjects (78.7%), normal body weight per age 117 (78.5%), and normal body weight per body height 94 (63.1%). The clinical findings included cough 47 subjects (31.5%), fever 36 subjects (24.2%), cold 28 subjects (18.8%), and shortness of breath 20 subjects (13.4%). Meanwhile, in physical examination, rhonchi was found in 19 subjects (12.8%), lymphocytosis in 59 subjects (59.1%), leukocytosis in 49 subjects (32.9%), and normal chest radiograph was found in 94 subjects (63.1%). The outcome of patients 80.3% recovered, 19.7% referred, and 0% died. CONCLUSION: The clinical picture of children with COVID-19 at UNRAM Hospital was dominated by cough and fever, normal anthropometric status, leukopenia, normal radiological examination, and mostly patient outcomes were recovered.
{"title":"Clinical Profile, Laboratory, Radiology and Outcomes of COVID-19 Patients in Children at Mataram University Hospital","authors":"Linda Silvana Sari, Titi Prambudi Karuniawaty, P. A. Wiguna","doi":"10.3889/oamjms.2023.11578","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11578","url":null,"abstract":"BACKGROUND: Coronavirus disease 2019 (COVID-19) is atypical pneumonia that has spread since December 2019 and named as severe acute respiratory syndrome coronavirus 2.\u0000AIM: This study aimed to understand the characteristics of pediatric patients with COVID-19 from the aspect of clinical picture, anthropometric status, and laboratory and radiology findings in Mataram University Hospital.\u0000MATERIALS AND METHODS: This qualitative study with descriptive approach. A total of 149 subjects were collected based on the purposive sampling.\u0000RESULTS: This study was dominated by female gender (59.1%), age under 12 months old (81.9%), normal body height per age 113 subjects (78.7%), normal body weight per age 117 (78.5%), and normal body weight per body height 94 (63.1%). The clinical findings included cough 47 subjects (31.5%), fever 36 subjects (24.2%), cold 28 subjects (18.8%), and shortness of breath 20 subjects (13.4%). Meanwhile, in physical examination, rhonchi was found in 19 subjects (12.8%), lymphocytosis in 59 subjects (59.1%), leukocytosis in 49 subjects (32.9%), and normal chest radiograph was found in 94 subjects (63.1%). The outcome of patients 80.3% recovered, 19.7% referred, and 0% died.\u0000CONCLUSION: The clinical picture of children with COVID-19 at UNRAM Hospital was dominated by cough and fever, normal anthropometric status, leukopenia, normal radiological examination, and mostly patient outcomes were recovered.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42172814","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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