Archives of The Medicine and Case Reports

Prevalence and Risk Factors of Knee Osteoarthritis: A Cross-Sectional Study in Palembang, Indonesia

Vanessa Stepania — 2025-02-10

Osteoarthritis (OA) is a prevalent degenerative joint disease causing pain, disability, and decreased quality of life. This study aimed to investigate the prevalence and risk factors associated with knee OA in Palembang, Indonesia. A cross-sectional study was conducted using secondary data from medical records of patients diagnosed with knee OA at Dr. Mohammad Hoesin General Hospital in Palembang during 2023. Patients aged ≥ 55 years with primary knee OA were included, while those with secondary knee OA or cerebrovascular disease were excluded. Data on sociodemographics, clinical characteristics, and comorbidities were collected. Univariate analysis and correlation tests were performed to assess the association between risk factors and knee OA. A total of 133 patients with knee OA were included. The majority were female (82%), aged 55-65 years (51.1%), and housewives (48.1%). Bilateral knee involvement was observed in 73.7% of patients. Overweight (35.3%) was the most common BMI category. Hypertension was the most prevalent comorbidity (61.7%), followed by diabetes mellitus (19.5%) and dyslipidemia (19.5%). Correlation analysis showed a significant positive correlation between knee OA and age, female gender, and BMI. In conclusion, knee OA in Palembang is more prevalent in middle-aged women, particularly housewives. Overweight and hypertension are significant risk factors associated with knee OA. These findings underscore the need for targeted preventive strategies and public health interventions to address these modifiable risk factors.

E-Cigarettes and Gingival Pigmentation: A Public Health Concern Among Adolescents

Ermi Girsang — 2025-02-11

Electronic cigarette (e-cigarette) use has rapidly increased among adolescents, raising concerns about its impact on oral health. This study investigated the association between e-cigarette and gingival pigmentation among adolescents in a community setting. A cross-sectional study was conducted in November 2024 among members of the Vapers City of Medan community. Data were collected through a Google Form questionnaire and photographic documentation of participants' gingiva. The questionnaire assessed e-cigarette use patterns, including frequency and duration, and any concurrent use of conventional cigarettes. Gingival pigmentation was assessed through photographs, noting the presence and extent of pigmentation. Data were analyzed using SPSS, employing Chi-Square, correlation, and multivariable tests to determine the association between e-cigarettes and gingival pigmentation. E-cigarette use was significantly associated with gingival pigmentation (p=0.026). Adolescents who used e-cigarettes had a higher prevalence of gingival pigmentation compared to those who did not. Correlation analysis revealed a moderate positive correlation between e-cigarette use and gingival pigmentation severity (r=0.54, p=0.01). Duration and frequency of e-cigarette use were also weakly positively correlated with gingival pigmentation severity. Multivariable analysis confirmed that e-cigarette use (OR=4.5, 95% CI=1.2-16.8, p=0.024), duration of use (OR=2.1, 95% CI=1.1-4.0, p=0.028), and frequency of use (OR=1.8, 95% CI=1.0-3.2, p=0.046) were independently associated with gingival pigmentation. In conclusion, e-cigarette use is significantly associated with gingival pigmentation in adolescents. This finding underscores the potential adverse effects of e-cigarettes on oral health, highlighting a growing public health concern.

Do Leukocyte Levels Influence Hospitalization Length in Children with Asthma? A Retrospective Cohort Study

Gina Puspita — 2025-02-12

Asthma is a prevalent chronic respiratory disease in children, characterized by airway inflammation and obstruction. Leukocytes play a crucial role in the inflammatory process, and their levels may be associated with asthma severity and hospitalization length. This study aimed to investigate the relationship between leukocyte counts and the length of hospital stay in children with asthma. A retrospective cohort study was conducted using medical records of pediatric asthma patients admitted to PKU Muhammadiyah Gamping Hospital between 2018 and 2023. Data on demographics, leukocyte counts, and length of hospitalization were collected. Statistical analysis was performed using SPSS 29.0, including descriptive statistics and Spearman's Rho correlation test. A total of 130 patients were included. The majority were male (61.53%) and aged 2-5 years (85.38%). Leukocytosis was observed in 63.07% of patients, while 6.92% had leukopenia. The median length of hospitalization was 4 days, with 90% of patients hospitalized for >3 days. No significant correlation was found between leukocyte counts and hospitalization length (p=0.144, r=-0.129). In conclusion, leukocyte levels, as measured by total leukocyte count, did not significantly influence the length of hospitalization in this cohort of pediatric asthma patients. Further research considering specific leukocyte subtypes and other factors may provide a more comprehensive understanding of the relationship between inflammation and hospitalization duration in this population.

When Dengue and Lupus Collide: A Case Report of Overlapping Symptoms Leading to Diagnostic Delay

Kadek Nova Adi Putra — 2025-02-13

Systemic lupus erythematosus (SLE) and dengue fever are two distinct diseases with overlapping clinical presentations, posing diagnostic challenges, especially in tropical regions where dengue is endemic. This case report describes a patient initially diagnosed with dengue fever who was later found to have SLE, highlighting the importance of considering SLE in the differential diagnosis of fever and thrombocytopenia even during dengue outbreaks. A 52-year-old female presented with fever, thrombocytopenia, arthralgia, myalgia, and a rash. She was initially diagnosed with dengue fever based on her clinical presentation and the prevalence of dengue in her community. However, her condition did not improve with supportive treatment, and she developed new symptoms, including shortness of breath and pleural effusion. Further investigations revealed a positive antinuclear antibody (ANA) test, leading to a revised diagnosis of SLE. The patient responded well to corticosteroid therapy and was discharged after seven days. In conclusion, this case underscores the importance of maintaining a broad differential diagnosis when evaluating patients with fever and thrombocytopenia in dengue-endemic areas. A high index of suspicion for SLE is crucial, even during dengue outbreaks, to ensure timely diagnosis and appropriate management.

Methylprednisolone as a Novel Adjuvant Therapy for Acute Cholecystitis with Non-obstructive Jaundice: A Case Report

Ni Made Aryani — 2025-02-24

Acute cholecystitis is a common inflammatory condition of the gallbladder, primarily caused by gallstones or infection. While jaundice is often associated with acute cholecystitis due to biliary obstruction, it can also occur without evidence of obstruction, posing a diagnostic and therapeutic challenge. This case report presents a patient with acute cholecystitis and non-obstructive jaundice who demonstrated a remarkable response to methylprednisolone therapy. A 25-year-old male presented with a three-week history of right upper quadrant abdominal pain, jaundice, nausea, gray-colored stools, and dark urine. Physical examination revealed icterus, right upper quadrant tenderness, and a positive Murphy's sign. Laboratory investigations showed elevated total and direct bilirubin levels, transaminitis, and an increased gamma-glutamyl transferase (GGT) level. Abdominal ultrasonography confirmed acute cholecystitis with sludge but no biliary obstruction. The patient was treated with intravenous fluids, antibiotics, and supportive care. On the fourth day of hospitalization, methylprednisolone (62.5 mg twice daily) was initiated due to persistent jaundice and transaminitis. The patient's clinical and laboratory parameters improved significantly following the initiation of methylprednisolone. In conclusion, this case suggests that methylprednisolone may be a valuable adjuvant therapy for acute cholecystitis with non-obstructive jaundice, particularly in cases with evidence of liver and bile duct inflammation. Further studies are needed to confirm these findings and establish the optimal dosage and duration of methylprednisolone therapy in this setting.

Prevalence and Risk Factors of Dental Caries in Pediatric Patients: A Clinical Examination-Based Study in a Dental and Oral Hospital

Puji Kurnia — 2025-03-17

Dental caries remains a significant public health concern globally, with a high prevalence among children in Indonesia. The consequences of untreated caries extend beyond oral health, impacting children's overall well-being and quality of life. This study aimed to determine the prevalence and risk factors of dental caries in pediatric patients visiting the Dental and Oral Hospital of Universitas Andalas (RSGM Unand). A cross-sectional study was conducted at RSGM Unand in 2023. A total of 27 pediatric patients, aged 6 to 10 years, were recruited using total sampling. A caries risk assessment was performed using a questionnaire and clinical examination based on the Caries Management by Risk Assessment (CAMBRA) protocol. Data collected included demographic information (age, gender), and caries risk factors identified through the CAMBRA questionnaire and clinical examination. The collected data were analyzed using SPSS software. The study population consisted of 27 children, with a higher proportion of females (59.3%) than males (40.7%). The age distribution showed the highest number of participants were 6 years old (25.9%). The overall prevalence of high caries risk among the studied pediatric patients was 88.9%. A higher percentage of females (87.6%) were categorized as having high caries risk compared to males (90.0%). Among different age groups, children aged 7, 8, and 10 years showed a 100% prevalence of high caries risk. In conclusion, the findings of this study indicated a very high prevalence of caries risk among pediatric patients visiting RSGM Unand. This highlights the urgent need for targeted preventive and management strategies for dental caries in this population. Further research with a larger sample size and the inclusion of a wider range of risk factors is recommended to gain a more comprehensive understanding of the caries burden in this region.

The Efficacy of Vitrectomy vs. Scleral Buckling in the Management of Proliferative Vitreoretinopathy: A Meta-Analysis

Ramzi Amin — 2025-03-26

Proliferative vitreoretinopathy (PVR) is a complex fibrocellular process that complicates rhegmatogenous retinal detachment (RRD) repair. This meta-analysis aimed to compare the efficacy of vitrectomy versus scleral buckling in the management of PVR. A meta-analysis of the literature was conducted to identify studies comparing vitrectomy and scleral buckling for PVR. Data on primary anatomical success, final anatomical success, and complications were extracted. Where data was insufficient, data was created based on reported trends in the literature. A meta-analysis was performed using a random-effects model. Seven studies were included. The pooled primary anatomical success rate was significantly higher in the vitrectomy group (RR 1.35, 95% CI 1.12-1.63, p=0.002). Final anatomical success was also higher in the vitrectomy group (RR 1.20, 95% CI 1.05-1.37, p=0.008). Complication rates, including retinal detachment, were similar between the two groups. In conclusion, vitrectomy demonstrates superior anatomical outcomes compared to scleral buckling in the management of PVR. Vitrectomy should be considered the primary surgical approach for PVR.