Citra Utami Effendy, Sri Wahyu Maryuni, Veenda Herlyna Pertiwi
Background: Gartner’s duct cysts are benign vaginal cysts originating from embryological remnants. While usually asymptomatic, larger cysts can mimic pelvic organ prolapse, leading to misdiagnosis and delayed treatment. This case emphasizes the importance of accurate diagnosis and appropriate surgical intervention in managing large GDCs. Case presentation: A 43-year-old woman presented with a protruding vaginal mass, initially mistaken for pelvic organ prolapse. Examination revealed a large Gartner’s duct cyst on the posterior vaginal wall. Surgical excision and marsupialization were performed, confirming the diagnosis. Conclusion: This case highlights the importance of thorough evaluation in women presenting with vaginal masses. Large Gartner’s duct cysts, though rare, can mimic pelvic organ prolapse, necessitating accurate diagnosis and appropriate surgical intervention.
{"title":"Giant Gartner’s Duct Cyst Mimicking Pelvic Organ Prolapse: A Rare Case Report","authors":"Citra Utami Effendy, Sri Wahyu Maryuni, Veenda Herlyna Pertiwi","doi":"10.37275/bsm.v8i11.1109","DOIUrl":"https://doi.org/10.37275/bsm.v8i11.1109","url":null,"abstract":"Background: Gartner’s duct cysts are benign vaginal cysts originating from embryological remnants. While usually asymptomatic, larger cysts can mimic pelvic organ prolapse, leading to misdiagnosis and delayed treatment. This case emphasizes the importance of accurate diagnosis and appropriate surgical intervention in managing large GDCs. \u0000Case presentation: A 43-year-old woman presented with a protruding vaginal mass, initially mistaken for pelvic organ prolapse. Examination revealed a large Gartner’s duct cyst on the posterior vaginal wall. Surgical excision and marsupialization were performed, confirming the diagnosis. \u0000Conclusion: This case highlights the importance of thorough evaluation in women presenting with vaginal masses. Large Gartner’s duct cysts, though rare, can mimic pelvic organ prolapse, necessitating accurate diagnosis and appropriate surgical intervention.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"48 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141805009","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: Malignant central airway obstruction (MCAO) significantly impacts the quality of life and prognosis of patients with advanced lung cancer or metastatic disease. This meta-analysis aims to evaluate the effectiveness and safety of various management strategies for MCAO. Methods: A systematic search of PubMed, Embase, and Cochrane databases from 2018 to 2024 was conducted to identify randomized controlled trials (RCTs) and observational studies comparing different MCAO management approaches. Primary outcomes included improvement in airway patency, dyspnea scores, and survival. Secondary outcomes included procedural complications and quality-of-life measures. A random-effects model was used to pool data, and heterogeneity was assessed using the I² statistic. Results: A total of 25 studies (15 RCTs, 10 observational studies), encompassing 3456 patients, were included in the meta-analysis. Interventions assessed were rigid bronchoscopy with various modalities (e.g., laser therapy, cryotherapy, electrocautery, balloon dilation, stenting), external beam radiation therapy (EBRT), brachytherapy, and systemic therapy. Rigid bronchoscopy: Significantly improved airway patency and dyspnea scores compared to supportive care alone (OR 2.86, 95% CI 1.95-4.18; p<0.001). Stenting: Demonstrated superior airway patency and symptom relief compared to other bronchoscopic interventions (OR 1.73, 95% CI 1.21-2.48; p=0.003). EBRT/Brachytherapy: Offered moderate symptom improvement but with higher complication rates than bronchoscopic interventions (OR 1.39, 95% CI 1.05-1.85; p=0.021). Systemic therapy (chemotherapy/immunotherapy): Provided limited benefit in terms of airway patency but may impact overall survival in specific tumor types. Conclusion: Rigid bronchoscopy, particularly with stenting, is the most effective initial management strategy for MCAO, providing rapid symptom relief and airway recanalization. EBRT/brachytherapy can be considered as adjuncts or alternatives in select cases. Further research is needed to determine the optimal combination and sequencing of therapies for different tumor types and stages.
背景：恶性中央气道阻塞（MCAO）严重影响晚期肺癌或转移性疾病患者的生活质量和预后。本荟萃分析旨在评估各种MCAO治疗策略的有效性和安全性。方法：对2018年至2024年的PubMed、Embase和Cochrane数据库进行了系统检索，以确定比较不同MCAO管理方法的随机对照试验（RCT）和观察性研究。主要结果包括气道通畅性改善、呼吸困难评分和存活率。次要结果包括手术并发症和生活质量指标。采用随机效应模型汇总数据，并使用 I² 统计量评估异质性。结果：共有25项研究（15项研究性临床试验、10项观察性研究）被纳入荟萃分析，涉及3456名患者。评估的干预措施包括硬质支气管镜检查与各种方式（如激光治疗、冷冻治疗、电灼、球囊扩张、支架植入）、体外放射治疗（EBRT）、近距离放射治疗和全身治疗。硬质支气管镜检查：与单纯支持治疗相比，气道通畅率和呼吸困难评分显著改善（OR 2.86，95% CI 1.95-4.18；P<0.001）。支架植入术：与其他支气管镜干预相比，气道通畅率和症状缓解率更优（OR 1.73，95% CI 1.21-2.48；P=0.003）。EBRT/近距离放射治疗：可适度改善症状，但并发症发生率高于支气管镜介入疗法（OR 1.39，95% CI 1.05-1.85；P=0.021）。全身治疗（化疗/免疫治疗）：对气道通畅性的益处有限，但可能会影响特定肿瘤类型的总体生存率。结论硬质支气管镜检查，尤其是支架植入术，是 MCAO 最有效的初始治疗策略，可迅速缓解症状并重新疏通气道。在特定病例中，EBRT/近距离放射治疗可作为辅助手段或替代方法。需要进一步研究确定不同肿瘤类型和分期的最佳治疗组合和顺序。
{"title":"Meta-Analysis of Effective Management Strategies for Malignant Central Airway Obstruction","authors":"Septriana Putri, Y. Sabri, Fenty Anggrainy","doi":"10.37275/bsm.v8i11.1108","DOIUrl":"https://doi.org/10.37275/bsm.v8i11.1108","url":null,"abstract":"Background: Malignant central airway obstruction (MCAO) significantly impacts the quality of life and prognosis of patients with advanced lung cancer or metastatic disease. This meta-analysis aims to evaluate the effectiveness and safety of various management strategies for MCAO. \u0000Methods: A systematic search of PubMed, Embase, and Cochrane databases from 2018 to 2024 was conducted to identify randomized controlled trials (RCTs) and observational studies comparing different MCAO management approaches. Primary outcomes included improvement in airway patency, dyspnea scores, and survival. Secondary outcomes included procedural complications and quality-of-life measures. A random-effects model was used to pool data, and heterogeneity was assessed using the I² statistic. \u0000Results: A total of 25 studies (15 RCTs, 10 observational studies), encompassing 3456 patients, were included in the meta-analysis. Interventions assessed were rigid bronchoscopy with various modalities (e.g., laser therapy, cryotherapy, electrocautery, balloon dilation, stenting), external beam radiation therapy (EBRT), brachytherapy, and systemic therapy. Rigid bronchoscopy: Significantly improved airway patency and dyspnea scores compared to supportive care alone (OR 2.86, 95% CI 1.95-4.18; p<0.001). Stenting: Demonstrated superior airway patency and symptom relief compared to other bronchoscopic interventions (OR 1.73, 95% CI 1.21-2.48; p=0.003). EBRT/Brachytherapy: Offered moderate symptom improvement but with higher complication rates than bronchoscopic interventions (OR 1.39, 95% CI 1.05-1.85; p=0.021). Systemic therapy (chemotherapy/immunotherapy): Provided limited benefit in terms of airway patency but may impact overall survival in specific tumor types. \u0000Conclusion: Rigid bronchoscopy, particularly with stenting, is the most effective initial management strategy for MCAO, providing rapid symptom relief and airway recanalization. EBRT/brachytherapy can be considered as adjuncts or alternatives in select cases. Further research is needed to determine the optimal combination and sequencing of therapies for different tumor types and stages.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"33 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810104","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: Malnutrition is a prevalent issue in hospital settings, significantly impacting patient outcomes and healthcare costs. This study aimed to identify and analyze risk factors associated with malnutrition and its influence on the length of stay (LOS) among hospitalized patients at Klungkung General Hospital, Indonesia. Methods: A retrospective observational study was conducted, including adult patients admitted to Klungkung General Hospital between January 1, 2023, and December 31, 2023. Malnutrition was assessed using the Subjective Global Assessment (SGA) tool. Patient demographics, medical history, nutritional status, laboratory parameters, and LOS were collected. Univariate and multivariate analyses were performed to identify risk factors associated with malnutrition and its impact on LOS. Results: A total of 43,949 patients were included in the study, with 1,084 (2.46%) identified as malnutrition. The mean LOS for malnutrition patients was significantly longer than for well-nutrition patients (7.8 days vs. 4.2 days, p < 0.001). Multivariate analysis revealed that age ≥ 60 years (OR 2.31, 95% CI 1.85-2.89), presence of comorbidities (OR 1.75, 95% CI 1.42-2.16), low albumin levels (OR 2.05, 95% CI 1.68-2.50), and inadequate dietary intake (OR 1.98, 95% CI 1.61-2.43) were independent risk factors for malnutrition. Malnutrition was also an independent predictor of prolonged LOS (OR 1.68, 95% CI 1.36-2.07). Conclusion: Malnutrition is a significant problem at Klungkung General Hospital, associated with increased LOS. Early identification of risk factors and implementation of targeted nutritional interventions are crucial to improve patient outcomes and reduce healthcare costs.
背景：营养不良是医院环境中普遍存在的问题，严重影响患者的治疗效果和医疗成本。本研究旨在识别和分析与营养不良相关的风险因素及其对印度尼西亚克隆功综合医院住院患者的住院时间（LOS）的影响。研究方法进行了一项回顾性观察研究，研究对象包括2023年1月1日至2023年12月31日期间在克隆功综合医院住院的成人患者。采用主观全面评估（SGA）工具对营养不良情况进行评估。此外，还收集了患者的人口统计学资料、病史、营养状况、实验室参数和住院时间。进行了单变量和多变量分析，以确定与营养不良相关的风险因素及其对 LOS 的影响。结果研究共纳入 43,949 名患者，其中 1,084 人（2.46%）被确定为营养不良。营养不良患者的平均住院日明显长于营养良好患者（7.8 天对 4.2 天，P < 0.001）。多变量分析显示，年龄≥60 岁（OR 2.31，95% CI 1.85-2.89）、合并症（OR 1.75，95% CI 1.42-2.16）、白蛋白水平低（OR 2.05，95% CI 1.68-2.50）和饮食摄入不足（OR 1.98，95% CI 1.61-2.43）是营养不良的独立风险因素。营养不良也是住院时间延长的独立预测因素（OR 1.68，95% CI 1.36-2.07）。结论营养不良是克隆功综合医院的一个重要问题，与住院时间延长有关。及早识别风险因素并实施有针对性的营养干预措施对于改善患者预后和降低医疗成本至关重要。
{"title":"Analysis of Risk Factors Related to Malnutrition on Length of Stay Hospitalization: A Single-Center Observational Study at Klungkung General Hospital, Indonesia","authors":"I. D. G. W. Saskara, Christian","doi":"10.37275/bsm.v8i11.1107","DOIUrl":"https://doi.org/10.37275/bsm.v8i11.1107","url":null,"abstract":"Background: Malnutrition is a prevalent issue in hospital settings, significantly impacting patient outcomes and healthcare costs. This study aimed to identify and analyze risk factors associated with malnutrition and its influence on the length of stay (LOS) among hospitalized patients at Klungkung General Hospital, Indonesia. \u0000Methods: A retrospective observational study was conducted, including adult patients admitted to Klungkung General Hospital between January 1, 2023, and December 31, 2023. Malnutrition was assessed using the Subjective Global Assessment (SGA) tool. Patient demographics, medical history, nutritional status, laboratory parameters, and LOS were collected. Univariate and multivariate analyses were performed to identify risk factors associated with malnutrition and its impact on LOS. \u0000Results: A total of 43,949 patients were included in the study, with 1,084 (2.46%) identified as malnutrition. The mean LOS for malnutrition patients was significantly longer than for well-nutrition patients (7.8 days vs. 4.2 days, p < 0.001). Multivariate analysis revealed that age ≥ 60 years (OR 2.31, 95% CI 1.85-2.89), presence of comorbidities (OR 1.75, 95% CI 1.42-2.16), low albumin levels (OR 2.05, 95% CI 1.68-2.50), and inadequate dietary intake (OR 1.98, 95% CI 1.61-2.43) were independent risk factors for malnutrition. Malnutrition was also an independent predictor of prolonged LOS (OR 1.68, 95% CI 1.36-2.07). \u0000Conclusion: Malnutrition is a significant problem at Klungkung General Hospital, associated with increased LOS. Early identification of risk factors and implementation of targeted nutritional interventions are crucial to improve patient outcomes and reduce healthcare costs.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"40 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141809387","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}
Suci Leni Mimanda, Ennesta Asri, Indah Indria Sari
Background: Hypopigmented mycosis fungoides (HMF) is an uncommon variant of mycosis fungoides (MF), a cutaneous T-cell lymphoma. It presents a diagnostic challenge due to its clinical resemblance to various benign dermatological conditions. This case report highlights the importance of a comprehensive approach to diagnosis, incorporating clinical, histopathological, and immunohistochemical findings. Case presentation: A 48-year-old Indonesian woman presented with a one-year history of progressive, asymptomatic hypopigmented patches on her extremities. Initially misdiagnosed as progressive macular hypomelanosis, the patient's condition did not improve with topical treatments. Clinical examination revealed multiple hypopigmented patches and macules on both extremities, with some lesions exhibiting fine scales. Histopathological examination demonstrated atypical lymphocytes with epidermotropism and Pautrier's microabscesses. Immunohistochemical staining confirmed the presence of CD3+ T-cells, leading to the diagnosis of HMF. Conclusion: HMF can mimic various dermatological conditions, making diagnosis challenging. A thorough clinical assessment, coupled with histopathological and immunohistochemical evaluation, is crucial for accurate diagnosis and appropriate management. This case underscores the importance of considering HMF in the differential diagnosis of hypopigmented skin lesions, particularly in individuals with persistent or atypical presentations. Early recognition and intervention are essential for optimizing patient outcomes.
背景：色素沉着真菌病（HMF）是皮肤T细胞淋巴瘤--真菌病（MF）的一种不常见的变异型。由于其临床表现与各种良性皮肤病相似，因此给诊断带来了挑战。本病例报告强调了结合临床、组织病理学和免疫组化结果进行综合诊断的重要性。病例介绍：一名 48 岁的印度尼西亚妇女因四肢出现进行性、无症状的色素减退斑块已有一年病史。患者最初被误诊为进行性黄斑色素减退症，经外用药治疗后病情未见好转。临床检查发现，患者双侧肢体上有多处色素减退斑和斑丘疹，部分皮损有细小鳞屑。组织病理学检查显示，非典型淋巴细胞具有表皮向性和保特里尔氏微脓肿。免疫组化染色证实了 CD3+ T 细胞的存在，从而确诊为 HMF。结论HMF 可模拟各种皮肤病，因此诊断具有挑战性。全面的临床评估以及组织病理学和免疫组化评估对于准确诊断和适当治疗至关重要。本病例强调了在色素减退性皮肤病的鉴别诊断中考虑 HMF 的重要性，尤其是对表现持续或不典型的患者。早期识别和干预对于优化患者预后至关重要。
{"title":"Case of Hypopigmented Mycosis Fungoides: Clinical and Pathological Discrimination from Mimicking Conditions","authors":"Suci Leni Mimanda, Ennesta Asri, Indah Indria Sari","doi":"10.37275/bsm.v8i11.1106","DOIUrl":"https://doi.org/10.37275/bsm.v8i11.1106","url":null,"abstract":"Background: Hypopigmented mycosis fungoides (HMF) is an uncommon variant of mycosis fungoides (MF), a cutaneous T-cell lymphoma. It presents a diagnostic challenge due to its clinical resemblance to various benign dermatological conditions. This case report highlights the importance of a comprehensive approach to diagnosis, incorporating clinical, histopathological, and immunohistochemical findings. \u0000Case presentation: A 48-year-old Indonesian woman presented with a one-year history of progressive, asymptomatic hypopigmented patches on her extremities. Initially misdiagnosed as progressive macular hypomelanosis, the patient's condition did not improve with topical treatments. Clinical examination revealed multiple hypopigmented patches and macules on both extremities, with some lesions exhibiting fine scales. Histopathological examination demonstrated atypical lymphocytes with epidermotropism and Pautrier's microabscesses. Immunohistochemical staining confirmed the presence of CD3+ T-cells, leading to the diagnosis of HMF. \u0000Conclusion: HMF can mimic various dermatological conditions, making diagnosis challenging. A thorough clinical assessment, coupled with histopathological and immunohistochemical evaluation, is crucial for accurate diagnosis and appropriate management. This case underscores the importance of considering HMF in the differential diagnosis of hypopigmented skin lesions, particularly in individuals with persistent or atypical presentations. Early recognition and intervention are essential for optimizing patient outcomes.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810012","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: Dengue shock syndrome (DSS) is a life-threatening complication of dengue infection characterized by plasma leakage, shock, and organ dysfunction. Fluid management is crucial in DSS, but fluid overload can lead to adverse outcomes. This case report highlights the challenges and strategies in managing DSS with fluid overload. Case presentation: An 8-year-old girl presented with severe dengue, DSS, encephalopathy, and fluid overload. She had a history of high fever, vomiting, and altered consciousness. Initial management focused on fluid resuscitation, but the patient developed signs of fluid overload. Hemodynamic monitoring using USCOM (Ultrasonic Cardiac Output Monitor) revealed low cardiac output and high systemic vascular resistance. Fluid restriction and inotropic support with epinephrine were initiated. The patient's condition gradually improved, and she was discharged after complete recovery. Conclusion: This case emphasizes the importance of early recognition and careful monitoring of fluid status in DSS. Hemodynamic monitoring tools like USCOM can aid in guiding fluid management and identifying complications like fluid overload. Prompt intervention with fluid restriction and inotropic support can improve outcomes in DSS patients with fluid overload.
{"title":"Shock Management and Hemodynamic Monitoring of Severe Dengue with Fluid Overload: A Case Report","authors":"Shinta Asbi, Indra Ihsan, Rinang Mariko","doi":"10.37275/bsm.v8i11.1105","DOIUrl":"https://doi.org/10.37275/bsm.v8i11.1105","url":null,"abstract":"Background: Dengue shock syndrome (DSS) is a life-threatening complication of dengue infection characterized by plasma leakage, shock, and organ dysfunction. Fluid management is crucial in DSS, but fluid overload can lead to adverse outcomes. This case report highlights the challenges and strategies in managing DSS with fluid overload. \u0000Case presentation: An 8-year-old girl presented with severe dengue, DSS, encephalopathy, and fluid overload. She had a history of high fever, vomiting, and altered consciousness. Initial management focused on fluid resuscitation, but the patient developed signs of fluid overload. Hemodynamic monitoring using USCOM (Ultrasonic Cardiac Output Monitor) revealed low cardiac output and high systemic vascular resistance. Fluid restriction and inotropic support with epinephrine were initiated. The patient's condition gradually improved, and she was discharged after complete recovery. \u0000Conclusion: This case emphasizes the importance of early recognition and careful monitoring of fluid status in DSS. Hemodynamic monitoring tools like USCOM can aid in guiding fluid management and identifying complications like fluid overload. Prompt intervention with fluid restriction and inotropic support can improve outcomes in DSS patients with fluid overload.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":" 57","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141826750","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: Psoriasis vulgaris (PV) is a chronic inflammatory skin disease with a multifactorial etiology, including genetic, immunological, and environmental factors. Obesity, characterized by a high body mass index (BMI), has been increasingly recognized as a potential risk factor for PV and may influence its severity. This study aimed to analyze the relationship between various risk factors, particularly BMI, and the severity of PV. Methods: A cross-sectional study was conducted at a dermatology outpatient clinic of Dr. Moewardi Surakarta Hospital. Patients with a confirmed PV diagnosis were enrolled. Demographic data, medical history, lifestyle factors (smoking, alcohol consumption), and anthropometric measurements (height, weight, BMI) were collected. PV severity was assessed using the psoriasis area and severity index (PASI). Statistical analysis, including univariate and multivariate logistic regression, was performed to identify associations between risk factors and PV severity. Results: The study included 200 PV patients with a mean age of 45.2 years (SD = 12.8) and a male predominance (58%). The mean PASI score was 12.4 (SD = 8.6), indicating a wide range of disease severity. Multivariate analysis revealed that obesity (BMI ≥ 30 kg/m2) was significantly associated with increased PV severity (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.5-5.2, p = 0.001). Smoking (OR = 1.9, 95% CI = 1.1-3.3, p = 0.02) and a family history of psoriasis (OR = 2.3, 95% CI = 1.3-4.1, p = 0.004) were also identified as independent risk factors for higher PASI scores. Alcohol consumption showed a borderline association with increased severity (OR = 1.6, 95% CI = 1.0-2.6, p = 0.05). Conclusion: Obesity, smoking, and a family history of psoriasis are significant risk factors for increased PV severity. These findings underscore the importance of addressing modifiable risk factors, such as weight management and smoking cessation, in the holistic management of PV. Further research is warranted to elucidate the underlying mechanisms linking these risk factors to PV severity and to develop targeted interventions to improve patient outcomes.
{"title":"Analysis of Risk Factors and Body Mass Index Against Degrees of Severity of Psoriasis Vulgaris","authors":"Lifesia Natali Lidjaja, M. Irawanto, Nurachmat Mulianto, Arie Kusumawardani, Vrenda Alia, Lifesia Natali, Lidjaja","doi":"10.37275/bsm.v8i10.1104","DOIUrl":"https://doi.org/10.37275/bsm.v8i10.1104","url":null,"abstract":"Background: Psoriasis vulgaris (PV) is a chronic inflammatory skin disease with a multifactorial etiology, including genetic, immunological, and environmental factors. Obesity, characterized by a high body mass index (BMI), has been increasingly recognized as a potential risk factor for PV and may influence its severity. This study aimed to analyze the relationship between various risk factors, particularly BMI, and the severity of PV. \u0000Methods: A cross-sectional study was conducted at a dermatology outpatient clinic of Dr. Moewardi Surakarta Hospital. Patients with a confirmed PV diagnosis were enrolled. Demographic data, medical history, lifestyle factors (smoking, alcohol consumption), and anthropometric measurements (height, weight, BMI) were collected. PV severity was assessed using the psoriasis area and severity index (PASI). Statistical analysis, including univariate and multivariate logistic regression, was performed to identify associations between risk factors and PV severity. \u0000Results: The study included 200 PV patients with a mean age of 45.2 years (SD = 12.8) and a male predominance (58%). The mean PASI score was 12.4 (SD = 8.6), indicating a wide range of disease severity. Multivariate analysis revealed that obesity (BMI ≥ 30 kg/m2) was significantly associated with increased PV severity (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.5-5.2, p = 0.001). Smoking (OR = 1.9, 95% CI = 1.1-3.3, p = 0.02) and a family history of psoriasis (OR = 2.3, 95% CI = 1.3-4.1, p = 0.004) were also identified as independent risk factors for higher PASI scores. Alcohol consumption showed a borderline association with increased severity (OR = 1.6, 95% CI = 1.0-2.6, p = 0.05). \u0000Conclusion: Obesity, smoking, and a family history of psoriasis are significant risk factors for increased PV severity. These findings underscore the importance of addressing modifiable risk factors, such as weight management and smoking cessation, in the holistic management of PV. Further research is warranted to elucidate the underlying mechanisms linking these risk factors to PV severity and to develop targeted interventions to improve patient outcomes.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141826114","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: Atypical eclampsia, characterized by seizures without the classic signs of hypertension and proteinuria, presents a diagnostic and therapeutic challenge in the critical management aspect. This case report highlights the critical management of recurrent seizures in a young primigravida with atypical eclampsia. Case presentation: A 16-year-old primigravida at 38 weeks gestation presented with recurrent generalized tonic-clonic seizures. Despite initial magnesium sulfate therapy, seizures persisted postpartum. The patient was managed with a combination of midazolam and dexmedetomidine for seizure control and sedation. After five days of intensive care, the patient recovered without further complications. Conclusion: This case underscores the importance of considering atypical eclampsia in pregnant women presenting with seizures, even in the absence of typical preeclampsia symptoms. The successful use of midazolam and dexmedetomidine in this case suggests their potential as alternative therapeutic agents for refractory seizures in eclampsia. Further research is needed to validate these findings and establish optimal treatment protocols for atypical eclampsia.
{"title":"Critical Management of Recurrent Seizure at 16-Year-Old Primigravida with Atypical Eclampsia: A Case Report","authors":"Putu Ari, HS Kamanjaya, Febri Jaya, Gunawan","doi":"10.37275/bsm.v8i10.1103","DOIUrl":"https://doi.org/10.37275/bsm.v8i10.1103","url":null,"abstract":"Background: Atypical eclampsia, characterized by seizures without the classic signs of hypertension and proteinuria, presents a diagnostic and therapeutic challenge in the critical management aspect. This case report highlights the critical management of recurrent seizures in a young primigravida with atypical eclampsia. \u0000Case presentation: A 16-year-old primigravida at 38 weeks gestation presented with recurrent generalized tonic-clonic seizures. Despite initial magnesium sulfate therapy, seizures persisted postpartum. The patient was managed with a combination of midazolam and dexmedetomidine for seizure control and sedation. After five days of intensive care, the patient recovered without further complications. \u0000Conclusion: This case underscores the importance of considering atypical eclampsia in pregnant women presenting with seizures, even in the absence of typical preeclampsia symptoms. The successful use of midazolam and dexmedetomidine in this case suggests their potential as alternative therapeutic agents for refractory seizures in eclampsia. Further research is needed to validate these findings and establish optimal treatment protocols for atypical eclampsia.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829039","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: Non-alcoholic fatty liver disease (NAFLD) is an increasing global health problem. Probiotics have emerged as a potential therapy for NAFLD, but evidence for their efficacy remains mixed. This meta-analysis aims to evaluate the effectiveness of probiotics in the management of NAFLD. Methods: A comprehensive literature search was performed on PubMed, Embase, Cochrane Library, and Web of Science databases until December 2023. Randomized controlled trials (RCTs) evaluating the effects of probiotics in NAFLD patients were included. The main outcomes evaluated were changes in liver enzymes (ALT, AST), insulin resistance index (HOMA-IR), and hepatic steatosis score. Meta-analysis was performed using a random effects model, and heterogeneity was assessed using the I² statistic. Results: Twenty-five RCTs involving 1845 patients met inclusion criteria. Meta-analysis showed that probiotics significantly reduced ALT (MD -8.45; 95% CI -12.67 to -4.23; p<0.0001) and AST (MD -6.89; 95% CI -10.11 to -3.67; p<0.0001) levels compared with placebo. Significant reductions were also observed in HOMA-IR (MD -0.68; 95% CI -1.02 to -0.34; p<0.0001) and hepatic steatosis scores (SMD -0.45; 95% CI -0.71 to -0.19; p=0.0008). Subgroup analysis showed that the effects of probiotics were more pronounced in patients with NAFLD non-alcoholic steatohepatitis (NASH) and those receiving multi-strain probiotics. Conclusion: This meta-analysis provides strong evidence that probiotics have beneficial effects on biochemical and imaging parameters in NAFLD patients. Probiotics may be considered as an adjunct therapy for NAFLD, especially in patients with NASH. However, more research is needed to determine the optimal probiotic strain, dosage, and duration of treatment.
背景：非酒精性脂肪肝（NAFLD）是一个日益严重的全球性健康问题。益生菌已成为治疗非酒精性脂肪肝的一种潜在疗法，但有关其疗效的证据仍然参差不齐。本荟萃分析旨在评估益生菌在非酒精性脂肪肝治疗中的有效性。研究方法在 PubMed、Embase、Cochrane Library 和 Web of Science 数据库中进行了全面的文献检索，直至 2023 年 12 月。纳入了评估益生菌对非酒精性脂肪肝患者影响的随机对照试验（RCT）。评估的主要结果是肝酶（ALT、AST）、胰岛素抵抗指数（HOMA-IR）和肝脏脂肪变性评分的变化。采用随机效应模型进行 Meta 分析，并使用 I² 统计量评估异质性。分析结果符合纳入标准的有 25 项研究，涉及 1845 名患者。元分析表明，与安慰剂相比，益生菌能显著降低谷丙转氨酶（MD -8.45；95% CI -12.67 至 -4.23；p<0.0001）和谷草转氨酶（MD -6.89；95% CI -10.11 至 -3.67；p<0.0001）水平。HOMA-IR（MD -0.68；95% CI -1.02 至 -0.34；p<0.0001）和肝脏脂肪变性评分（SMD -0.45；95% CI -0.71至 -0.19；p=0.0008）也有显著降低。亚组分析显示，益生菌对非酒精性脂肪肝（NAFLD）非酒精性脂肪性肝炎（NASH）患者和接受多菌株益生菌治疗的患者的效果更明显。结论这项荟萃分析提供了强有力的证据，证明益生菌对非酒精性脂肪肝患者的生化指标和影像学指标有益处。益生菌可作为非酒精性脂肪肝的辅助疗法，尤其是对非酒精性脂肪肝患者。然而，还需要更多的研究来确定最佳益生菌菌株、剂量和疗程。
{"title":"Analysis of Probiotic Role in Non-Alcoholic Fatty Liver Disease (NAFLD) Management: A Meta-Analysis","authors":"Jesika Wulandari, Vidi Orba Busro","doi":"10.37275/bsm.v8i10.1088","DOIUrl":"https://doi.org/10.37275/bsm.v8i10.1088","url":null,"abstract":"Background: Non-alcoholic fatty liver disease (NAFLD) is an increasing global health problem. Probiotics have emerged as a potential therapy for NAFLD, but evidence for their efficacy remains mixed. This meta-analysis aims to evaluate the effectiveness of probiotics in the management of NAFLD. \u0000Methods: A comprehensive literature search was performed on PubMed, Embase, Cochrane Library, and Web of Science databases until December 2023. Randomized controlled trials (RCTs) evaluating the effects of probiotics in NAFLD patients were included. The main outcomes evaluated were changes in liver enzymes (ALT, AST), insulin resistance index (HOMA-IR), and hepatic steatosis score. Meta-analysis was performed using a random effects model, and heterogeneity was assessed using the I² statistic. \u0000Results: Twenty-five RCTs involving 1845 patients met inclusion criteria. Meta-analysis showed that probiotics significantly reduced ALT (MD -8.45; 95% CI -12.67 to -4.23; p<0.0001) and AST (MD -6.89; 95% CI -10.11 to -3.67; p<0.0001) levels compared with placebo. Significant reductions were also observed in HOMA-IR (MD -0.68; 95% CI -1.02 to -0.34; p<0.0001) and hepatic steatosis scores (SMD -0.45; 95% CI -0.71 to -0.19; p=0.0008). Subgroup analysis showed that the effects of probiotics were more pronounced in patients with NAFLD non-alcoholic steatohepatitis (NASH) and those receiving multi-strain probiotics. \u0000Conclusion: This meta-analysis provides strong evidence that probiotics have beneficial effects on biochemical and imaging parameters in NAFLD patients. Probiotics may be considered as an adjunct therapy for NAFLD, especially in patients with NASH. However, more research is needed to determine the optimal probiotic strain, dosage, and duration of treatment.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141837901","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: Vitamin D deficiency during pregnancy is associated with poor pregnancy outcomes. Research shows a complex interaction between iron and vitamin D. Pregnant women are susceptible to iron deficiency due to increased iron requirements during pregnancy. Ferritin reflects body iron stores and may decrease before serum iron. This study aims to analyze the relationship between ferritin levels and vitamin D status in pregnant women. Methods: This retrospective comparative cross-sectional analytical observational study involved pregnant women in the 1st, 2nd, and 3rd trimesters who underwent antenatal care at Hermina Hospital Padang from February to August 2023. Vitamin D (25(OH)D3) and ferritin were measured using enzyme-linked fluorescence assay (ELFA). Univariate and bivariate analysis used the Chi-square and odds ratio (OR) tests, with a significance of p<0.05. Results: Of 163 pregnant women (mean age 30.4 years), median ferritin levels were 25.85 ng/mL and 25(OH)D3 15.5 ng/mL. Low ferritin was found in 63.80% of subjects and sufficient vitamin D in 31.90%, insufficiency in 33.74%, and deficiency in 34.36%. There was no correlation between low ferritin and vitamin D insufficiency (OR=2.04; 95% CI 0.94-4.42; p=0.700). However, there was a significant correlation between low ferritin and vitamin D deficiency (OR=6.59; 95% CI 2.68-16.18; p=0.000). Conclusion: Pregnant women with low ferritin have a 6.59 times higher risk of experiencing vitamin D deficiency.
背景：孕期维生素 D 缺乏与不良妊娠结局有关。研究表明，铁和维生素 D 之间存在复杂的相互作用。由于怀孕期间对铁的需求增加，孕妇很容易缺铁。铁蛋白能反映体内的铁储存量，并可能先于血清铁下降。本研究旨在分析孕妇铁蛋白水平与维生素 D 状态之间的关系。研究方法这项回顾性比较横断面分析观察研究涉及 2023 年 2 月至 8 月期间在巴东赫米纳医院接受产前护理的第一、第二和第三孕期孕妇。采用酶联荧光测定法（ELFA）测量维生素 D（25（OH）D3）和铁蛋白。采用卡方检验（Chi-square）和几率比验（OR）进行单变量和双变量分析，显著性检验（P<0.05）。结果在 163 名孕妇（平均年龄 30.4 岁）中，铁蛋白水平的中位数为 25.85 纳克/毫升，25(OH)D3 为 15.5 纳克/毫升。63.80%的受试者铁蛋白偏低，31.90%的受试者维生素 D 充足，33.74%的受试者维生素 D 不足，34.36%的受试者维生素 D 缺乏。低铁蛋白与维生素 D 不足之间没有相关性（OR=2.04；95% CI 0.94-4.42；P=0.700）。然而，低铁蛋白与维生素 D 缺乏之间存在明显的相关性（OR=6.59；95% CI 2.68-16.18；P=0.000）。结论铁蛋白偏低的孕妇出现维生素 D 缺乏症的风险是正常孕妇的 6.59 倍。
{"title":"The Role of Ferritin Levels on Vitamin D Status in Pregnant Women: An Observational Single Center Study at Hermina Hospital, Padang, Indonesia","authors":"Hedo Hidayat, Efrida, Elfira Yusri","doi":"10.37275/bsm.v8i9.1070","DOIUrl":"https://doi.org/10.37275/bsm.v8i9.1070","url":null,"abstract":"Background: Vitamin D deficiency during pregnancy is associated with poor pregnancy outcomes. Research shows a complex interaction between iron and vitamin D. Pregnant women are susceptible to iron deficiency due to increased iron requirements during pregnancy. Ferritin reflects body iron stores and may decrease before serum iron. This study aims to analyze the relationship between ferritin levels and vitamin D status in pregnant women. \u0000Methods: This retrospective comparative cross-sectional analytical observational study involved pregnant women in the 1st, 2nd, and 3rd trimesters who underwent antenatal care at Hermina Hospital Padang from February to August 2023. Vitamin D (25(OH)D3) and ferritin were measured using enzyme-linked fluorescence assay (ELFA). Univariate and bivariate analysis used the Chi-square and odds ratio (OR) tests, with a significance of p<0.05. \u0000Results: Of 163 pregnant women (mean age 30.4 years), median ferritin levels were 25.85 ng/mL and 25(OH)D3 15.5 ng/mL. Low ferritin was found in 63.80% of subjects and sufficient vitamin D in 31.90%, insufficiency in 33.74%, and deficiency in 34.36%. There was no correlation between low ferritin and vitamin D insufficiency (OR=2.04; 95% CI 0.94-4.42; p=0.700). However, there was a significant correlation between low ferritin and vitamin D deficiency (OR=6.59; 95% CI 2.68-16.18; p=0.000). \u0000Conclusion: Pregnant women with low ferritin have a 6.59 times higher risk of experiencing vitamin D deficiency.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"32 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141343207","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}
I. Gusti, Agung Dwi, Putri Anjani, Wayan Eka Saputra
Background: Dengue hemorrhagic fever (DHF) is a viral infection transmitted by Aedes mosquito with a wide clinical spectrum, ranging from mild fever to life-threatening complications. Atypical clinical manifestations of DHF can cause delays in diagnosis and treatment, so it is important to increase clinician awareness of these unusual manifestations. Case presentation: We report four cases of DHF with atypical manifestations: (1) A 50-year-old woman with spontaneous psoas hematoma, (2) An elderly man with pulmonary edema, (3) A young man with acute myocarditis, and (4) A middle-aged man. middle-aged with encephalopathy. Conclusion: Atypical manifestations of DHF can occur at various ages and can involve various organs. It is important for clinicians to consider dengue fever as a differential diagnosis in patients with fever and unusual clinical manifestations, especially in dengue-endemic areas. Early diagnosis and appropriate treatment can improve patient clinical outcomes.
{"title":"Dengue Haemorrhagic Fever with Unusual Presentations and Complications in Sanjiwani General Hospital: A Case Series","authors":"I. Gusti, Agung Dwi, Putri Anjani, Wayan Eka Saputra","doi":"10.37275/bsm.v8i9.1068","DOIUrl":"https://doi.org/10.37275/bsm.v8i9.1068","url":null,"abstract":"Background: Dengue hemorrhagic fever (DHF) is a viral infection transmitted by Aedes mosquito with a wide clinical spectrum, ranging from mild fever to life-threatening complications. Atypical clinical manifestations of DHF can cause delays in diagnosis and treatment, so it is important to increase clinician awareness of these unusual manifestations. \u0000Case presentation: We report four cases of DHF with atypical manifestations: (1) A 50-year-old woman with spontaneous psoas hematoma, (2) An elderly man with pulmonary edema, (3) A young man with acute myocarditis, and (4) A middle-aged man. middle-aged with encephalopathy. \u0000Conclusion: Atypical manifestations of DHF can occur at various ages and can involve various organs. It is important for clinicians to consider dengue fever as a differential diagnosis in patients with fever and unusual clinical manifestations, especially in dengue-endemic areas. Early diagnosis and appropriate treatment can improve patient clinical outcomes.","PeriodicalId":503226,"journal":{"name":"Bioscientia Medicina : Journal of Biomedicine and Translational Research","volume":"15 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141349000","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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