Bali Medical Journal最新文献

{"title":"A rare nasal myiasis in a patient with diabetes mellitus","authors":"Teguh Rahardjo, Yoseph Jappi, S. Wibisono","doi":"10.15562/bmj.v11i3.3660","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3660","url":null,"abstract":"Background: Nasal myiasis, a type of cavitary myiasis, is an infestation of parasitic insect larvae or eggs in the nasal cavity of the human body. The risk of nasal myiasis increases in individuals with immunocompromised such as diabetes mellitus (DM). The aim of this study was to report a rare case of nasal myiasis in a patient with DM.\u0000Case Presentation: A 54-year-old female patient was referred to Dr. Soetomo General Hospital Surabaya with a chief complaint of spontaneous anterior epistaxis from the left nostril for three days. Anterior rhinoscopy revealed a narrowed left nasal cavity covered with excessive bloody discharge and>50 larvae coming out of the nasal passage. Nasoendoscopy showed ulcerated lesions on the left nasal cavity floor and nasal lateral wall, destructions of the osteomeatal complex and lateral wall, thick bloody discharge with excessive crust, as well as a larva around the osteomeatal complex entering the maxillary sinus. Paranasal sinus CT scan showed no further infection to surrounding organs. The patient had a history of type 2 DM for the past 2.5 years. The patient was diagnosed with nasal myiasis, unregulated type 2 DM, and diabetic neuropathy. Therapies included larval removal by endoscopy, wound irrigation using antiseptic solutions, maxillary sinus irrigation, administration of the topical antiparasitic ivermectin, and insulin therapy. After seven days of the treatment, the patient was discharged from the hospital with a resolved infection and controlled blood sugar levels.\u0000Conclusion: Awareness of risk factors for myiasis along with proper therapy is prominent. Nasal endoscopy, together with nasal irrigation and antiparasitic drug administration was effective in the management of nasal myiasis.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44316222","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}

{"title":"Recurrent seizures as manifestation of hypoparathyroidism-related hypocalcemia in a patient with post-subtotal thyroidectomy","authors":"Febrian Daru Setiawan, H. Novida","doi":"10.15562/bmj.v11i3.3659","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3659","url":null,"abstract":"Background: Hypocalcemia, a condition where the serum calcium concentration or total serum calcium is below normal, could be associated with various manifestations including severe symptoms requiring immediate hospitalization. The condition can cause by several causes including iatrogenic thyroidectomy. Here, we report a patient of hypocalcemia associated with hypoparathyroidism due to post-thyroidectomy.\u0000Case presentation: A 32-year-old woman admitted to the hospital complained of stiffness and tingling in the extremities accompanied by recurrent seizures. The serum calcium level was low and this hypocalcemia condition was associated with low parathyroid hormone levels after subtotal thyroidectomy surgery. Laboratory examination indicated calcium 4.8 mg/dL and parathyroid hormone 2.21 pg/ml. The patient had bradycardia with prolonged QT on electrocardiography (ECG) and developed cataracts in both eyes which could be associated with chronic hypocalcemia. The patient's condition improved after correction of hypocalcemia. After discharge, the patient was given calcium and levothyroxine supplementation due to hypothyroid conditions.\u0000Conclusion: The hypocalcemia condition in the patient was associated with low parathyroid hormone level post-subtotal thyroidectomy surgery. This case highlights the impotence of detailed analyses of hormonal, radiological and histological investigations of patients with thyroid gland diseases to diagnose such conditions early and to ensure timely management.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45155935","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}

{"title":"Secondary syphilis mimicking mid-borderline leprosy in HIV-positive patient","authors":"Rheza Rahmadika Putra, U. Hadi","doi":"10.15562/bmj.v11i3.3688","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3688","url":null,"abstract":"Background: Syphilis increases the risk of HIV transmission. Coinfection of both infectious diseases potentially changes the presentation of mucocutaneous lesions and accelerates disease progression, complicating the diagnosis and treatment with standard regimens. In the case study, we present a case of secondary syphilis in an HIV-positive patient with clinical manifestations resembling mid-borderline leprosy.\u0000Case presentation: A 23-year-old male patient was referred to the emergency care unit of Dr. Soetomo General Hospital with red spots on the palms of the hands and soles of the feet for the past four months. The skin manifestation first appeared as a single spot, grew over time with itch and pain. The patient had lost 15 kg of body weight in the last three months which was confirmed as HIV-positive. He was also treated for leprosy based on the skin manifestations ever since. There was no history of direct contact with leprosy patients. The patient admitted that he had sex with men in the last 3-4 years. The laboratory examination showed negative results for Mycobacterium leprae through skin biopsy and negative for IgM and IgG of anti-phenolic glycolipid-1 (PGL-1). The patient however was positive for syphilis due to high titers of venereal disease research laboratory/rapid plasma regain (VDRL/RPR) and treponema pallidum hemagglutination (TPHA), supported by histological findings. The patient’s condition improved after receiving penicillin benzathine G, the definitive treatment for syphilis.\u0000Conclusion: Secondary syphilis is a great imitator to mid-borderline leprosy, especially in HIV patients. To avoid misdiagnosis and mistreatment, a careful physical and laboratory examination, including serology and histopathology, should be carried out.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43958985","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}

{"title":"Liver function characteristics of COVID-19 patients with obesity at Dr. Soetomo Hospital: case series","authors":"Erwin Maulana, Farmanda Putra, U. Maimunah","doi":"10.15562/bmj.v11i3.3727","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3727","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) patients with obesity are more susceptible to liver injury. There is currently no published overview regarding COVID-19 patients with liver injury in Indonesia. Our study reported 7 cases of obese COVID-19 patients with an increase of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT), followed by 5 of them developing severe symptoms of COVID-19 in isolation room of Dr. Soetomo Hospital Surabaya within June-December 2020.\u0000Case Presentation: A total of 7 COVID-19 patients, by the average age 46.2±15.5 years, were obese. The mean body mass index (BMI) was 36,3±3,4 kg/m2. Five of them experienced serious symptoms. There were 3 patients (patient no. 2, 4, 7) who had normal SGOT level, while the rest had an increased SGOT level for <2x upper limit of normal (ULN) at admission. During treatment, SGOT level increased in 5 patients for 1-<3x ULN and normal in the rest of them (patient no. 2, 4). Meanwhile, the normal SGPT levels were shown in 3 patients (patient no. 2, 4, 7) and increased in 4 others at admission for 1-<4x ULN. All of them tended to have an increased SGPT level during treatment for 1-<5x ULN. However, since the increase of SGOT and/or SGPT for >3x ULN is defined as liver injury, it happened in 2 patients that occur since admission (patient no. 3) and during treatment (patient no. 5).\u0000Conclusion: Obesity may impede the recovery of COVID-19 and manifest in the deterioration of liver function.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45242580","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}

{"title":"Platelet-rich fibrin (PRF) graft and amniotic membrane graft on transforming growth factor-β (TGF-β) and type 1 collagen post conjunctival excision","authors":"Abdi Roy Nababan, Daniar Indah Suryowati, Evelyn Komaratih, Yulia Primitasari, D. Legowo, P. B. Notopuro, H. Notobroto","doi":"10.15562/bmj.v11i3.3733","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3733","url":null,"abstract":"Background: Conjunctiva, when injured, can heal spontaneously. However, in extensive wounds, wound healing is often accompanied by scarring and wound contraction. Currently, for cases of disease and trauma to the surface of the eyeball, it can be reconstructed using the amniotic membrane, but there are still weaknesses in the use of amnion. Platelet-rich fibrin (PRF) is currently being developed for the reconstruction of ocular surface wounds.\u0000Methods: A total of 20 male New Zealand rabbits (20 eyes) were divided into two groups. In the first group, conjunctival excision and PRF membrane graft suturing were performed on the right eye conjunctival defect, while the second group had an amniotic membrane sutured on the right eye conjunctival defect. On the 14th day, enucleation was carried out and continued with histopathological examination using immunohistochemistry using TGF antibodies and type 1 collagen to evaluate the levels of TGF and type 1 collagen in the conjunctiva.\u0000Results: The results after 14 days of treatment showed that there was a very significant difference in TGF Beta expression between the AMT group and the PRF group (p = 0.007*; <0.05). However, in the expression of type 1 collagen, there was no significant difference in the expression of type 1 collagen between the AMT group and the PRF group (p = 0.791; >0.05).\u0000Conclusion: There were differences in the expression of TGF-β and type 1 collagen in the administration of the PRF membrane compared to the administration of the amniotic membrane after conjunctival excision of experimental male New Zealand rabbits on day 14.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45306583","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}

{"title":"Peripheral blood abnormality in Sezary Syndrome with bacteremia","authors":"Wizar Putri Mellaratna, Zubir, Juwita Sahputri, Irwandi","doi":"10.15562/bmj.v11i3.3675","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3675","url":null,"abstract":"Introduction: Sezary syndrome defined as a set of symptoms consist of erythroderma, generalized lymphadenopathy, and Sezary cells were detected in peripheral blood, skin and lymph nodes.\u0000Case: Patients with chief complaints red and scaly patches cover almost part of the body accompanied by itching since 1 week ago. The patient had history of taking herbal medicines 2 weeks earlier. There is an erosion and crusting at inferior lips. There is also fissure at left side ventral hand region. There is no generalized lymphadenopathy. The patient has fever, hypertension and hyperglycemia. The laboratory result showed leukocytosis with Sezary cells > 1000 cells/mm3, and bacteremia (coccus). Differential diagnosis of patients was Sezary syndrome, drug-induced erythroderma and mycosis fungoides. The diagnosis was Sezary syndrome because erythroderma and Sezary cells > 1000 cells/ mm3 were found. The patient was treated with injection of corticosteroid, antibiotic, barrier repair moisturizer and potent topical corticosteroid.\u0000Conclusion: Sezary syndrome is often accompanied by bacteremia due to impaired skin barrier function and decreased cellular immunity. Examination of biopsy, bacterial culture and flow cytometer is required for diagnosis.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49386971","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}

{"title":"Effect of tartrazine on blood urea nitrogen, creatinine levels, and renal tubular necrosis in adult male Wistar rats (Rattus norvegicus): an experimental study","authors":"M. Rahayu, S. Wahyuni, Idha Fitriani, Habib Budiman Agung","doi":"10.15562/bmj.v11i3.3623","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3623","url":null,"abstract":"Introduction: Tartrazine is still one of the most widely used coloring agents in the pharmaceutical, cosmetic, and food industries; various hazardous consequences have been identified in rodents and humans, including impaired kidney function. This current study aimed to evaluate the effect of tartrazine on the biochemical parameters and structures of the kidney.\u0000Methods: Twenty-four adult male Wistar rats were divided into four groups of 6 each. The experimental animals received tartrazine orally at a dose of 3.75, 7.5, and 15 mg/kg body weight along with a normal diet. The control group received only food and drinking water. The study was carried out for 21 days. At the end of the experiment, biochemical (blood urea nitrogen and serum creatinine) and histopathological examinations were performed on animal kidney tissues.\u0000Results: Our findings revealed a significant increase in urea and creatinine levels in the serum of tartrazine-treated rats compared to controls (p < 0.05). The kidney section of rats treated with tartrazine showed lumen compression of tubular cells and loss of integrity of the renal tubule membrane. Tartrazine was associated with increases in the percentage of renal tubular necrosis in a dose-dependent manner compared to the control group (p < 0.05).\u0000Conclusions: The current study concluded that oral administration of tartrazine affected the kidney by increasing urea nitrogen, creatinine levels, and the percentage of renal tubular necrosis in male Wistar rats. The results showed that tartrazine intake could cause adverse kidney health effects.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46861627","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}

{"title":"Management options for primary umbilical endometriosis: a case report","authors":"Hilwah Nora, Ima Indirayani, Rusnaidi, Razi Maulana","doi":"10.15562/bmj.v11i3.3640","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3640","url":null,"abstract":"Background: The common location of Endometriosis is in genitalia organs, for instance, the ovary, uterus, fallopian tube, and sometimes even in the intestine, bladder, and in rare locations such as the navel, lungs, or brain. Umbilical Endometriosis is the most irregular form of Endometriosis and the most common cutaneous form of Endometriosis. Primary umbilical endometriosis diagnosis is often biased and delayed; the exact etiopathology remains unclear. Our case report discusses the diagnosis and management options for this rare disease.\u0000Case presentation: We reported a Primary Umbilical Endometriosis case, confirmed by a history of the nodule with pain, swelling, and bleeding at the umbilicus, which occurs during menstruation. The nodule was surgically removed, and histopathological analysis shows fibromycsoid tissue with multiple forms of subepithelial endometrial glands and surrounding stroma, confirmed as Endometriosis.\u0000Conclusion: The definitive treatment for umbilical Endometriosis is surgical excision with total removal of the umbilicus. The prognosis is good, and the recurrence rate is meager if complete excision is successfully performed.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41791562","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}

{"title":"Low dose bupivacaine spinal anesthesia for emergency cesarean section in a patient with uncorrected tetralogy of fallot, presenting with placenta previa","authors":"Anna Millizia","doi":"10.15562/bmj.v11i3.3674","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3674","url":null,"abstract":"Background: Pregnant women with congenital heart disease tetralogy of fallot who undergo cesarean section have their own challenges for the anesthesiologist, not to mention if they have pregnancy complications such as placenta previa. The choice of the safest anesthetic technique is still debated today. The anesthetic technique must be able to maintain systemic vascular resistance, avoid increasing pulmonary vascular resistance, and be aware of the threat of blood loss due to placenta previa.\u0000Case Report: 29 years old pregnant woman, weighing 46 kg and height 155 cm, G1P0A0, Gravida 27-28 weeks, single alive fetus, fetal distress, comes with complaints of shortness of breath, vaginal bleeding due to placenta previa with tetralogy of fallot planned emergency cesarean section. The patient presented with functional class NYHA II-III. We used low-dose spinal anesthesia with 5 mg bupivacaine 0.5% and 25 ug fentanyl as an adjuvant. Colloading was done with gelofusin colloid fluid to replace the amount of bleeding. Hemodynamics prior to anesthesia were BP 120/80, Heart Rate 80 x/minure, SpO2 72% with a non-rebreathing mask 10 litre/minute. There was no severe hypotension during surgery, and was hemodynamically stable with limited use of vasopressors. After the cesarean section was completed, the patient was transferred to the ICU and treated for 2 days, and was only discharged after 5 days of treatment without additional complications.\u0000Conclusion: The use of low-dose spinal anesthesia in combination with adjuvant fentanyl results in a relatively safe anesthetic technique with minimal hemodynamic changes and adequate analgesia for cesarean delivery.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42139712","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}

{"title":"Implementation of the blood donation preservation strategy at Indonesian red cross (IRC) blood donor unit (BDU) Banda Aceh during the COVID-19 pandemic","authors":"Teuku Ilhami Surya Akbar, Maulana Ikhsa, R. Dewi","doi":"10.15562/bmj.v11i3.3622","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3622","url":null,"abstract":"Background: The ongoing COVID-19 impacts the world of health, including IRC BDU. There is a need for a rapid response and countermeasures to meet the enormous challenge of balancing blood supply and demand. IRC BDU Banda Aceh in collaboration with the Aceh Government has carried out the civil servant (CS) movement for blood donation. This movement has been carried out since June 2020 until now. The CS donation movement is one of the IRC BDU strategies for the City of Banda Aceh in preserving donors during the COVID-19 pandemic. The study aims to see the impact of the COVID-19 pandemic and the implementation of strategies at IRC BDU Banda Aceh City on the number of blood donors at IRC BDU Banda Aceh City.\u0000Methods: This type of research is a descriptive study with a cross sectional survey design. The first quarter of the analysis was carried out to compare the initial period of the 2020 pandemic with the non-pandemic year 2019 to see the impact of the pandemic on the number of blood donors. The second quarter analyzed the impact of the 2020 pandemic with the implementation of the strategy carried out in 2021 on the number of blood donors at IRC BDU Banda Aceh.\u0000Results: There was a 12.8% decrease in the number of blood donors in the 2020 period compared to the 2019 period (Mann Whitney test, p-value = 0.038). This shows the impact of the COVID-19 pandemic on the decline in the number of blood donors at IRC BDU Banda Aceh in 2020. In the second quarter, the government's strategy to deal with the shortage of blood supply with the CS donor movement succeeded in increasing the number of blood donors by 12.7% (Mann Whitney test, p-value = 0.242) in 2021 (compared to 2020). This shows that the implementation of the COVID-19 handling strategy from the local government plays an important role in increasing the number of blood donors at IRC BDU Banda Aceh. but there was no significant difference in the average number of donors each month.\u0000Conclusion: Management and government participation in mobilizing blood donors and proper utilization are the keys to blood availability during the covid-19 pandemic era.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41269741","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}