International Journal of Biomedical Science and Travel Medicine

Vascular cognitive impairment after ischemic stroke

2024-03-30T08:31:18+07:00

Background Post-stroke cognitive impairment is the leading cause of post-stroke morbidity and mortality worldwide. This impairment is often associated with ischemic stroke and intracerebral hemorrhage. Cognitive impairment could affect attention, memory, language, orientation, and executive and social functioning domains.

Case We reported a male patient, 45 years old, Javanese, who came with confusion and memory impairment. When asked a question, the patient tends to think and answer slowly with a wrong response. He also felt weakness in the right half of the body, slurred speech, pursed lips, and had been diagnosed with ischemic stroke. One week after he was sent home, patient still had difficulty arranging words to form a sentence and could not work. Cognitive function screening showed impairment in attention and memory domain with a MOCA-INA score of 19/30. Patients received antihypertensive therapy, dual antiplatelet, statin, and cognitive stimulation. His condition improved with this treatment.

Conclusion Early identification of cognitive impairment could reduce morbidity in stroke patients.

Probability-based Equation for Predicting Mortality in COVID-19 Patients

2024-03-30T08:31:19+07:00

Background The global mortality rate for coronavirus disease-2019 (COVID-19) continues to climb. The study goal is to provide a proper equation to predict mortality in COVID-19 patients based on medical history, and laboratory examination

Methods This was a case-control study. Patients with COVID-19 confirmed case was taken for medical history, physical, and laboratory examination. CBC and D-Dimer were checked when patients were admitted to the hospital. Statistical analysis that was use include Chi-Square or Fisherâ€™s test as comparative study, risk estimate for odds ratio, and logistic regression to formulated the equation.

Results Ninety-six patients were gathered at the end of study. The study grouped patients based on survival at end of care which is life and death as dependent variable. We also grouped patients based on several parameter like geriatric age, comorbidities, symptoms (fever, cough, anosmia, cold, dysphagia, and shortness of breath), anemia, leukocytosis/leukopenia, thrombocytopenia, elevated D-Dimer, and pneumonia, as independent variables. Geriatric, comorbidities, fever, cough, shortness of breath, anemia, leukocytosis/leucopenia, lymphopenia, and elevated D-Dimer had significant differences with p < 0.05. Odds ratio and 95%CI for these parameters were 3.02 (1.11-8.20), 4.07 (1.35-12.27), 3.57 (0.96-13.23), 5.04 (1.08-23.34), 4.75 (1.02-22.02), 3.26 (1.15-9.25), 6.40 (2.19-18.63), 3.16 (0.97-10.30), and 0.70 (0.61-0.81), respectively. Multivariate analysis using logistic regression based on this result was calculated and we were able to make this probability equation, p = 1/(1+e-y), with e =2.7, and y = - 24.99 + 1.621(comorbidities) + 1.944(cough) + 1.643(leukocytosis/leukopenia) + 1.397(anemia) + 20.625(elevated D-Dimer). ROC was use to confirm this predicted probability with AUC 0.88

Conclusion This equation was simple enough to be used as tool for clinician to predict mortality in COVID-19 patients. If we were to assume that for example patient with COVID-19 with comorbidities had cough as symptoms, and also had leukocytosis/leukopenia, anemia, and elevated D-Dimer level based on laboratory result, then that patient had 90.25% probability of death as outcome. The study was able to predict death in COVID-19 patients with up to 90.25% probability using our equation with excellent discrimination between these patients

Diphtheritic Polyneuropathy: A Rare Complication that Needs to be Acknowledged

2024-03-30T08:31:20+07:00

Globally, diphtheria still poses a burden on public health, predominantly in developing countries. Poor vaccine coverage and boosters are the main factors in the diphtheria outbreak that should have been obliterated as the vaccine was invented a century ago. Health services are particularly burdened by diphtheria because it can lead to both short-term complications like acute airway obstruction and long-term complications like myocardial toxicity and diphtheritic polyneuropathy. Data about diphtheritic polyneuropathy is scarce, and physicians may not be aware of this condition. Herein we present the pathophysiology, clinical manifestation, diagnosis, and treatment of diphtheritic polyneuropathy.

Different Outcome in COVID-19 Patients with or without PPI Use: A Systematic Review and Meta-analysis

2024-03-30T08:31:20+07:00

Background The coronavirus disease (COVID-19) pandemic still happening and when itâ€™s going to be resolved is not known. In this COVID-19 era, physicians need to better understand the risk and purpose of giving drugs that patients do not need. Proton pump inhibitors (PPI) are sometimes easily prescribed and misused by physicians. The study objective is to find out whether PPI use is associated with better or worse outcomes in patients with COVID-19.

Method We searched retrospective studies in various publication libraries like PubMed, Embase, and CENTRAL from 2020 to 2022. Inclusion criteria were studied which differentiated patients with COVID-19 who regularly used PPI and control which is COVID-19 patients who did not use PPI. That study also needs to report the outcomes. The outcome was then divided into two categories which are good outcomes and worse outcomes consisting of severe COVID-19 needing oxygen therapy, admission to intensive care unit (ICU), acute respiratory distress syndrome (ARDS), shock or mortality, to get each study and total odd ratio (OR), 95% confidence interval, and weight. Studies that did not report the outcomes were excluded. We also analyze the data using a fixed or random effect model accordingly and asses the possibility of publication bias using Eggerâ€™s test.

Case Seven of 11 studies with more than 30.000 COVID-19 patients were analyzed in this study. These patients were divided into 2 groups: patients with COVID-19 who were using PPI up to 30 days before being infected and COVID-19 patients who didnâ€™t use PPI before. The total number of patients in the first group is 3531 patients and the second group is 38138 patients. After statistical analysis, we found that the data is heterogenous with p <0,05, I2 94,22% (95%CI 90,44-96,51%) suggesting the OR needs to be determined in the random effect model. We found that pooled OR is 1.99 (p 0.01, 95% CI, 1.18-3.38). Eggerâ€™s test for the possibility of publication bias is 0,64 (95%CI -7,24-4,93).

Conclusion COVID-19 patients who use PPI are twice as likely to have a worse outcome than COVID-19 patients who donâ€™t use PPI. This study is statistically significant with a low possibility of publication bias.

Evaluating Curcumin Intake on Metabolism-Related Genes in Drosophila melanogaster

2024-04-18T12:09:43+07:00

Background Aging entails a gradual deterioration of physiological functions within the body. Current research provides evidence suggesting that curcumin may extend the lifespan of fruit flies by mitigating the effects of aging. However, the precise concentration of curcumin necessary to induce favorable phenotypic and molecular outcomes in fruit flies has yet to be determined.

Method The study utilized the capillary feeder (CAFE) assay on male Oregon-R flies, and examined the expression of the srl and pepck genes through the reverse transcriptase quantitative PCR (RT-qPCR) method.

Case An elevation of curcumin consumption was examined in the treatment groups that were provided with feed containing curcumin concentrations of 50 Î¼M and 250 Î¼M. This observation is consistent with the increased lifespan noted in the Drosophila groups consuming higher concentrations of curcumin. Meanwhile, molecular analysis at the expression level of the srl and pepck genes revealed no significant change in gene expression between the treatment and control groups.

Conclusion The use of the CAFE assay assists researchers in quantitatively measuring the amount of curcumin intake in Drosophila melanogaster. However, the consumption of curcumin in this experiment did not demonstrate a significant impact on the metabolism-related genes of Drosophila, srl and pepck genes.