Sumatera Medical Journal

Breast Cancer Clinicopathology based on Neutrophil Levels at Adam Malik Hospital Medan in 2018-2021

Mon, 01 Jan 2024 00:00:00 +0700

Breast cancer is the most frequently diagnosed cancer in the world. Breast cancer occurs due to abnormal cell growth in breast tissue so that it becomes malignant. In Indonesia, breast cancer is the most common cancer in women. That way, many markers are needed as prognostic and predictive of breast cancer. One of the prognostic factors for breast cancer is neutrophil levels combined with clinicopathological factors. Knowing the clinicopathology of breast cancer based on neutrophil levels at the Haji Adam Malik Medan General Hospital in 2018-2021. The research design is observational with a descriptive method and calculated using the Lemeshow formula. Results: Majority aged 40-49 years (39.6%), high school (44.8%), housewives (67.7%), no family history (97.9%), tumor grade II (38.5%) %), Tumor Infiltrating Lymphocytes (TILs) severe (47.9 %), mitotic score 1 (38.5 %), metastatic positive lymph node status (87.5 %), tumor size T1 (36.5 %), The number of positive and negative Estrogen Receptors is the same (50.0%), Progesterone Receptor is negative (56.3%), HER2 is 1+ (60.4%), Ki-67 is positive (84 .4 %), positive angioinvasion (63.5 %), Invasive Ductal Carcinoma (90.6 %), high neutrophil levels (77.1 %). High levels of neutrophils tend to result in severe Tumor Infiltrating Lymphocytes (TILs) which will increase tumor growth, occurrence of metastases, increased positive angioinvasion, negative Estrogen Receptor status, negative Progesterone Receptor status, HER2 1+ status, positive Ki-67 status.

Level of Knowledge, Attitude, and Behavior of Students at SMA Negeri 13 Medan on Prevention of Sexually Transmitted Infections

Elisabeth, Maria Magdalena Simatupang, Delfitri Munir, Olga Rasiyanti Siregar — Mon, 01 Jan 2024 00:00:00 +0700

Sexually Transmitted Infection (STI) is a contagious disease that has been a health problem around people all over the world because the incidence rate of sexually transmitted diseases (STDs) tends to increase. Adolescence is a transitional period in which a person moves from childhood to adulthood. Adolescents have a great sense of curiosity, like adventures and challenges but without careful consideration of the risks they will face later on. According to UNICEF in 2019, of the 40 million people living with HIV/AIDS, more than a quarter are between 15 and 24 years old, half of the new HIV infections are currently occurring in young people 19 and every three minutes, one adolescent contracts HIV. It was happened because of the lack of knowledge of the teens understanding about sexual education and reproduction health that can lead to pregnancy at a young age and the high risk of contracting STI. This research objects to know the level of knowledge, attitudes and behavior of SMA Negeri 13 Medan students regarding STI prevention. Methods: This is descriptive research with cross-sectional design. The sampling technique is done by stratified random sampling with questionnaire as data collection tool and the data analysis was carried out using descriptive statistics. The results showed that the knowledge level of SMA Negeri 13 Medan students about preventing STI was mostly in the good category (54.2%), attitudes were in the good category (93.7%), and behaviors were in the moderate category (47.9%). Most of students have a good knowledge level, good attitude level, and moderate behavior level towards STI prevention.

A Study on Impact of Covid-19 on the Nutrition & Exercise Regime of Lifestyle Disorder Patients (Non-Communicable Disease)

Sheetal Mahendher, Shantanu Paul — Mon, 01 Jan 2024 00:00:00 +0700

The COVID-19 pandemic has significantly altered people's eating and activity habits all around the world. Lockdowns and social isolation policies have altered daily routines, changed people's levels of physical activity, and changed how they eat. The goal of this study is to comprehend how the pandemic has affected people with lifestyle problems, notably non-communicable diseases (NCDs), and their dietary and exercise habits. The goal of this study is to fill in the knowledge gaps regarding the effects of COVID-19 on people who have lifestyle disorders by studying the variations in exercise routines and the necessary nutrition intake during and after the lockdown. In order to gather information from people with NCDs, the study used a mixed-methods approach that combines a questionnaire survey and focused discussion. The findings highlight the pandemic's early collateral impacts, such as its detrimental effects on physical activity and dietary awareness. The study offers insights into how people with lifestyle disorders alter their exercise regimens, exercise style, and adherence to nutritional diets. The findings show that the pandemic has driven people to change their workout routines, moving away from gyms and outside activities toward alternate at-home techniques. The study also emphasizes the difficulties people encountered in sticking to rigorous nutritional diets during the epidemic because of the restricted availability of fresh and nourishing foods. It further highlights the significance of consistent exercise and mindful eating for those with lifestyle disorders, particularly during times of crisis.

Warm Autoimmune Hemolytic Anemia with Chronic Hepatitis B

Adefri Wahyudi, Fadrian, Rudy Afriant — Mon, 01 Jan 2024 00:00:00 +0700

Warm autoimmune hemolytic anemia (wAIHA) is caused by erithrocytes destruction by IgG or IgG plus C3d-mediated autoantibody. Long use steroids are first line therapy of wAIHA. It has risk infection reactivation, like chronic hepatitis B. Man, 64 y.o, hospitalized with diagnosis wAIHA and chronic hepatitis B. Diagnosis of wAIHA is built by: severe normocytic normochromic anemia, reticulocytosis 42.29%, increasing lactate dehydrogenase 397 U/L, direct Coombs test (+4), antibody screening IgG (+4). Anothers laboratorium findings: HbsAg (+), albumin 3.5 g/dL, ALT U/L, rapid HIV (-), anti HCV (-). There is no blast found in peripheral blood and bone marrow smear. Patient also diagnosed chronic hepatitis B inactive phase with negative HbeAg, HBV DNA 547 IU/L, normal liver finding in abdominal USG and moderate fibrosis from fibroscan. Washed red cell transfussion was administered, 2 x 125 mg methilprednisolone iv (3 days) tapering off until to 40 mg/day doses. He did not get antiviral prophylaxis and be planned to reevaluate in next 6 months. Steroid is first line therapy in wAIHA. When wAIHA is diagnosed, determination of chronic hepatitis B status should confirmed. There is a risk of reactivation of chronic hepatitis B infection so monitoring is needed.

Diabetic Ketoacidosis in Type 1 Diabetes Mellitus

Lukman Nurhakim, Rudy Afriant, Dinda Aprilia — Mon, 01 Jan 2024 00:00:00 +0700

Diabetic ketoacidosis (DKA) is a state of metabolic decompensation/disorder characterized by the triad of hyperglycemia, acidosis and ketosis, caused by absolute or relative insulin deficiency and increased counter-regulatory hormones. Immediate therapy in DKA patients determines the patient's prognosis. A 19-year-old male treated in the internal medicine ward of Dr. M djamil Padang with diabetic ketoacidosis, type 1 DM, and Abscess capitis. The patient was treated with rehydration and intravenous insulin infusion can show clinicall improvement. The diagnosis in patients is based on anamnesis, physical examination and supporting examinations. Immediate therapy is needed in the management of DKA in patients. After DKA is resolved, look for the causes of the risk of DKA. On the third day of treatment the patient's condition improved clinically and the laboratory.

The Diagnostic Challenge of Distinguishing Temporal Lobe Encephaloceles from Sphenoid Sinus Mucoceles

Ein Wan Chin, Liang Chye Goh , Aun Wee Chong — Mon, 01 Jan 2024 00:00:00 +0700

Temporal lobe encephaloceles are rare malformations defined as brain parenchyma herniation through a skull base structural defect into adjacent structure such as sphenoid sinus, while sphenoid sinus mucoceles are expansive cystic lesions caused by mucus buildup and thinning of the sinus wall, mostly involving the frontal and ethmoid sinus. Both illnesses may present similar clinical symptoms, such as neurological symptoms, nasal and ophthalmologic symptoms. However, misdiagnosis of temporal lobe encephaloceles can have significant clinical implications, as the best treatment plans vary depending on the disease. A 27-year-old healthy man who presented with seizure and loss of consciousness in public gave a history of head trauma 13 years back. Upon physical examination, the patient had normal cranial nerve function, and no cerebellar or meningitis signs. Rigid nasoendoscopy showed unremarkable findings. A computed tomography scan revealed an expanded left sphenoid sinus likely mucocele with a left temporal lobe encephalomalacia. Further investigations with brain magnetic resonance imaging (MRI) discovered temporal lobe encephalocele and transcranial repair of sphenoid encephalocele was arranged. Imaging results interpreted incorrectly may result in significant clinical ramifications. Distinguishing between both diseases with a complete investigation including MRI scan is crucial for appropriate management and treatment planning.

Review Article: Characteristics of Ovarian Cancer: Age, Epithelial Histopathology, Stages

Subhika Laksmi, Riza Rivany, Deri Edianto, Denny Rifsal Siregar — Mon, 01 Jan 2024 00:00:00 +0700

Ovarian cancer is a disease that has a high mortality rate, it has 185 thousand deaths in 2018. In Indonesia, it is estimated that there are 100 cancer patients per 100 thousand people. Ovarian cancer is a malignancy with no specific symptoms, as a result advanced stage is commonly found at diagnosis and there is no effective screening test to date. However, genetic factors have been found to play a role in this disease. The aim of this study is to find out the characteristics of ovarian cancer patients. Methods: This research uses a review article research design, with a narrative type. Data collection was taken from a collection of journals sourced from Pubmed and met the inclusion and exclusion criteria set by the author and then summarized. Six journals that included the characteristics of ovarian cancer patients are included in this review article. According to the six journals, the mean age is 54 years old, the most stage found is stage 3, and the most epithelial histopathology found is serous. According to the six journals that were reviewed, the characteristics of ovarian cancer patients based on age, stage, and epithelial histopathology were found to be consistent with the theory that has been established.

Herbal Therapies in Cancer Patients: Managing Side Effects and Improving Quality of Life

Keshav Anand, Harpreet Kaur Massaon, P. K. Prabhakar — Mon, 01 Jan 2024 00:00:00 +0700

This comprehensive review explores the role of herbal therapies in managing the side effects of cancer treatments and enhancing the quality of life for cancer patients. As conventional cancer treatments often induce a myriad of adverse effects, ranging from nausea and fatigue to pain and emotional distress, the integration of herbal therapies has gained attention as a potential complementary approach. The review synthesizes existing literature, drawing upon both preclinical and clinical studies, to evaluate the efficacy and safety of various herbs in alleviating common side effects associated with cancer therapies. Special emphasis is placed on the potential benefits of herbal interventions in addressing physical symptoms, such as nausea and pain, as well as psychological and emotional challenges faced by cancer patients. Furthermore, the review explores the mechanisms of action behind these herbal interventions and potential synergies with conventional treatments. Insights into patient perspectives and experiences with herbal therapies contribute to a holistic understanding of their impact on overall well-being. By providing a critical analysis of the current state of knowledge, this review aims to guide healthcare professionals, researchers, and patients in making informed decisions regarding the integration of herbal therapies into cancer care, ultimately improving the supportive care and quality of life for individuals undergoing cancer treatment.