Ahmad Fawzy | Medical Faculty University Of Jenderal Soedirman (original) (raw)

Papers by Ahmad Fawzy

Open Access Macedonian Journal of Medical Sciences, Feb 12, 2021

BACKGROUND: We investigated the epidemiology and the knowledge of first aid regarding to burns in... more BACKGROUND: We investigated the epidemiology and the knowledge of first aid regarding to burns in the rural area of Kulon Progo, located in Indonesia. Although 44% of Indonesia's population resides in rural areas, data of burn in Indonesia are very limited to national referral centers located in Indonesia's largest cities. We also surveyed the patients and families of these burn patients to try to understand their knowledge on the first aid of burns. AIM: We wanted to explore and discover what myths and misperceptions existed in rural communities. MATERIALS AND METHODS: A retrospective study analyzing the medical records of patients with burns admitted to two of Kulon Progo's largest referral hospitals between January 2018 and December 2019. A survey was distributed to the patients and their families regarding their knowledge on the first aid of burns. We wanted to analyze if certain groups of the population were more at risk for specific types of burn etiologies, the correlation between burn etiology and length of stay, the correlation between total body surface area (TBSA) of burns and length of stay in the hospital, and the correlation between education level of survey participants' and their knowledge of first aid of burns. RESULTS: A total of 115 patients were reviewed in this study. The highest proportion of total burn injuries occurred in the age group of 1-14 years old (38%). The major etiology of all burn cases were caused by scald (54%). Housewives and children were at a higher risk for scalds and laborers were at a higher risk for electrical and chemical burns (p = 0.001). There was no significant correlation between etiology and length of stay (p = 0.29). There was a statistically significant correlation between the TBSA and the length of hospital stay (p = 0.0001). The majority of survey respondents (66%) had poor knowledge on the first aid of burns. There was no significant correlation between education level and knowledge of first aid of burns (p = 0.07547). CONCLUSIONS: Children, laborers, and housewives have a significant risk of suffering from a burn injury. A majority of people still have poor knowledge on the first aid of burns. There was no correlation between education levels and knowledge of first aid burns.

International journal of medical science and clinical research studies, May 31, 2023

Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. ... more Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. hominid. Having scabies infestation coexisting in the same human body with a wound potentially lead to delayed wound healing. We constituted this literature review discussing wound healing in relation woth immunological state and oxidative stress in scabies infestation using information from literatures obtained from Google Scholar and PubMed. The immune response to scabies infection involves multiple layers of defense mechanisms, including the skin's defense mechanisms, T-cells, keratinocytes, and cytokines. Scabies mites can trigger upregulation of pro-inflammatory cytokines interleukins-1α (IL-1α) and interleukins-1β (IL-1β), which play a critical role in the early phases of wound healing by promoting the recruitment of immune cells and stimulating the production of growth factors and extracellular matrix proteins. Scabies mite infestation also triggers a sustained release of reactive oxygen species (ROS) from neutrophils which later becomes an oxidative stress leading to delayed healing and chronic inflammation. Topical treatment for scabies usually involves pesticide substances which, despite its therapeutic effect, have side effect of triggering ROS production. Comprehending the immunological state and oxidative stress in scabies infestation is essential in planning proper management for every wound with scabies comorbidity.

Zenodo (CERN European Organization for Nuclear Research), May 30, 2023

Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. ... more Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. hominid. Having scabies infestation coexisting in the same human body with a wound potentially lead to delayed wound healing. We constituted this literature review discussing wound healing in relation woth immunological state and oxidative stress in scabies infestation using information from literatures obtained from Google Scholar and PubMed. The immune response to scabies infection involves multiple layers of defense mechanisms, including the skin's defense mechanisms, T-cells, keratinocytes, and cytokines. Scabies mites can trigger upregulation of pro-inflammatory cytokines interleukins-1α (IL-1α) and interleukins-1β (IL-1β), which play a critical role in the early phases of wound healing by promoting the recruitment of immune cells and stimulating the production of growth factors and extracellular matrix proteins. Scabies mite infestation also triggers a sustained release of reactive oxygen species (ROS) from neutrophils which later becomes an oxidative stress leading to delayed healing and chronic inflammation. Topical treatment for scabies usually involves pesticide substances which, despite its therapeutic effect, have side effect of triggering ROS production. Comprehending the immunological state and oxidative stress in scabies infestation is essential in planning proper management for every wound with scabies comorbidity.

Zenodo (CERN European Organization for Nuclear Research), May 26, 2023

Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the intera... more Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the interaction between the innate and adaptive immune systems. The release of antimicrobial peptides (AMPs) by keratinocytes, particularly LL-37 peptides, plays a crucial role in the initiation of psoriatic inflammation. The activation of dendritic cells and distinct T-cell subsets, particularly Th1 and Th17, leads to the formation of scaly plaques in psoriasis. Although most cases are treated with topical or systemic medications, severe forms such as pustular psoriasis and psoriatic arthritis may require surgical management. Surgical procedures aim to relieve symptoms, improve function, and minimize scarring and cosmetic deformities. However, psoriatic patients are at higher risk of post-surgical infections and surgical stress may trigger psoriatic flare-ups. Thus, meticulous post-surgical wound care and psychological support are essential for optimal outcomes.

International Journal Of Medical Science And Clinical Research Studies

Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the intera... more Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the interaction between the innate and adaptive immune systems. The release of antimicrobial peptides (AMPs) by keratinocytes, particularly LL-37 peptides, plays a crucial role in the initiation of psoriatic inflammation. The activation of dendritic cells and distinct T-cell subsets, particularly Th1 and Th17, leads to the formation of scaly plaques in psoriasis. Although most cases are treated with topical or systemic medications, severe forms such as pustular psoriasis and psoriatic arthritis may require surgical management. Surgical procedures aim to relieve symptoms, improve function, and minimize scarring and cosmetic deformities. However, psoriatic patients are at higher risk of post-surgical infections and surgical stress may trigger psoriatic flare-ups. Thus, meticulous post-surgical wound care and psychological support are essential for optimal outcomes.

Indonesia Journal of Biomedical Science

Background:Capillary malformations (CMs) and Lymphatic malformation (LMs) are vascular malformati... more Background:Capillary malformations (CMs) and Lymphatic malformation (LMs) are vascular malformations that share a common tendency to cause soft and hard tissue hyperthropy, expressed in the three dimensions of the space. Although middle third of the face is the most commonly involved area, with a predominance of upper lip, the lower lip sometimes involved in some cases too. Vascular malformations of the lip often require reconstructive surgery with meticulous attention to both aesthetic and functional purposes. The lip reconstructive rule of thirds suggests that lower lip defects involving 1/3-2/3 total lip width require closure with lip switch or local advancement flap techniques (Karapandzic, Abbe, or Estlander).Case Description: 36 years old woman with bluish tumor lesion on lower lip since childhood, came to our clinic with history of  small lesion enlarging slowly, bluish in color, elastic in palpation, no bruit in auscultation. She had underwent surgery to reduce the size of ...

International Journal of Medical Science and Clinical Research Studies, 2023

Trichoepithelioma is a rare benign tumor, predominantly found on the face and scalp, with an uncl... more Trichoepithelioma is a rare benign tumor, predominantly found on the face and scalp, with an unclear prevalence in general population. Low incidence and lack of evidences, made trichoepithelioma management still a controversial domain in dermatology. Case: This study presented a 31-year-old woman with extensive trichoepithelioma on her nose, who underwent surgical excision and full-thickness skin grafting Result: Patient showed satisfaction with favorable aesthetic result and the consequent improvement in quality of her daily life. Discussion: Nasal intricate anatomy poses specific challenges in managing tumor like trichoepithelioma, emphasizing the importance of careful surgical planning. Surgical excision, Mohs surgery, and laser ablation are viable options, while non-surgical treatments such as topical therapies and cryotherapy are effective for superficial lesions. Patient satisfaction and quality of life are essential considerations, requiring open communication and psychological support. Emerging techniques, including advanced imaging, 3D bioprinting, and targeted molecular therapies, hold promise for optimizing trichoepithelioma management. Personalized approaches based on genetic profiling and collaborative research efforts are avenues for future exploration. Conclusion: Surgical management of trichoepithelioma on the nose, while challenging due to aesthetic concerns, can yield favorable outcomes. The approach to trichoepithelioma management should consider lesion size, surgical and non-surgical options and preference of the patient. Proper excision and meticulous skin grafting may provide aesthetically pleasant result. Personalized care, including psychological support, is crucial for post-surgery patient satisfaction. Multidisciplinary collaboration optimizes patient care in these unique cases.

International Journal of Medical Science and CLinical Research Studies, 2023

An episiotomy is a surgical incision in the perineum to facilitate the baby's head during deliver... more An episiotomy is a surgical incision in the perineum to facilitate the baby's head during delivery. Physicians or midwives may use this procedure if he/she finds out the tissue around the vaginal opening begins tearing or does not seem to be stretching enough to allow the baby to be delivered. With an increasing trend for hospital births and for physicians to get involved in the normal uncomplicated birth process, there was rise in the number of episiotomies. After the baby is delivered through the extended vaginal opening, the area is applied with local anesthetic agent and incision is repaired with sutures. Our study reviewed the development in the past twenty years regarding episiotomy wound closure methods, and discovered that continuous sutures for episiotomy or perineal repair have clinical advantages in term of faster and better wound healing, more favorable scarring, shorter post-procedural pain, more rapid resumption of sexual activity, lower incidence of urinary incontinence, compared to interrupted sutures. They were also beneficial in term of less consumption of suture materials. In determining suture materials, clinicians should strongly consider the tear severity, tissue characteristics, as well as the desired aesthetic outcome.

International Journal of Medical Science and Clinical Research Studies, 2023

Wound healing is a complex process critical for tissue repair post-injury. Botanicals, renowned i... more Wound healing is a complex process critical for tissue repair post-injury. Botanicals, renowned in traditional medicine, hold potential in wound healing due to their bioactive compounds. Etlingera elatior, a Zingiberaceae family member, is attracting attention for its diverse medicinal properties. Indigenous to Southeast Asia, it has been traditionally used for wound care, attributed to its anti-inflammatory, antioxidant, and antimicrobial effects. Recent scientific investigations highlight its ability to promote tissue repair, diminish inflammation, and counteract oxidative stress. These findings position Etlingera elatior as a promising candidate for wound healing management, particularly in plastic surgery. However, its clinical translation faces challenges, including limited clinical trials and mechanistic understanding, necessitating standardized extraction methods and regulatory approval. Bridging the gap between botanical therapies and clinical use requires robust clinical trials, mechanistic studies, and formulation optimization. Collaboration among researchers, clinicians, and regulators is pivotal in realizing Etlingera elatior's wound healing potential.

International Journal of Medical Science and Clinical Research Studies, 2023

Diabetic foot ulcers (DFUs) represent a significant health concern linked to poorly managed diabe... more Diabetic foot ulcers (DFUs) represent a significant health concern linked to poorly managed diabetes, affecting 19% to 34% of diabetic individuals and resulting in impaired functionality, infections, hospitalization, and the potential for amputations or mortality. Effective management involves addressing hyperglycemia, risk factors, and utilizing classification systems like SINBAD and IDSA/IWGDF for treatment. Skin grafting techniques such as split-thickness (STSG) and full-thickness (FTSG) grafts offer effective wound closure options. We acknowledged management for diabetic foot ulcers (DFUs) include autografts, cadaveric allografts, xenografts, and synthetic skin substitutes with natural polymers. Advanced techniques encompass biomaterials, nanobiomaterials, endothelial progenitor cells, and tissue engineering, while cellular therapies like mesenchymal stem cells (MSCs) show promise when properly activated. Innovations in DFU management encompass 3D bioprinting, nanotechnology, gene therapy, and photobiomodulation therapy. Positive clinical outcomes from skin grafting, including acellular fish skin (AFS) grafts, are observed, although challenges like graft rejection and limited technology awareness persist. Further research is essential to seamlessly integrate these advancements into DFU management for enhanced outcomes.

International Journal of Medical Science and Clinical Research Studies, 2023

Pediatric surgical wound care is a critical aspect of medical practice, necessitating innovative ... more Pediatric surgical wound care is a critical aspect of medical practice, necessitating innovative approaches to optimize healing and minimize complications. Platelet-rich plasma (PRP) therapy has emerged as a promising intervention for enhancing wound healing in pediatric patients. This review comprehensively evaluates the efficacy, underlying mechanisms, and challenges associated with platelet-rich plasma (PRP) therapy in the context of pediatric surgical wounds. Platelet-rich plasma (PRP), a biologic concentrate enriched with growth factors and cytokines, plays a pivotal role in wound healing by promoting cell proliferation, differentiation, and tissue regeneration. This article explores the mechanisms of action of this therapy in detail, focusing on its immunomodulatory effects and interaction with growth factors, and highlighting the significance of factors influencing platelet-rich plasma (PRP) efficacy, This article also gives examples of platelet-rich plasma (PRP) therapy in various pediatric surgical procedures, summarizes outcomes from clinical studies and trials, and addresses safety concerns and potential adverse effects associated with platelet-rich plasma (PRP) therapy in pediatric surgical wound management. In conclusion, this review underscores the potential of platelet-rich plasma (PRP) therapy as an adjunctive treatment in pediatric surgical wound care. By elucidating its mechanisms, clinical efficacy, and challenges, the review provides insights for clinicians and researchers to guide evidence-based practice. Recommendations for future research and the integration of platelet-rich plasma (PRP) therapy into clinical guidelines emphasize the importance of refining protocols, ensuring cost-effectiveness, and adhering to ethical standards in pediatric surgical wound care.

International Journal Of Medical Science And Clinical Research Studies

Introduction: Chemical burns are an uncommon form of burn injury, accounting for 2.1% to 6.5% of ... more Introduction: Chemical burns are an uncommon form of burn injury, accounting for 2.1% to 6.5% of all burn centre admissions. We presented one rare case of a second degree chemical burn due to successive contacts of acidic wart removal solution and paint mixture solution. Case: A 38-year-old male with chemical burn on both feet due to reckless usage of a self-purchased wart removal solution, and accidental contact with paint mixture solution. Our surgeon author diagnosed a superficial partial thickness (second-degree) chemical burn on this patient, and performed surgical debridement followed by hyaluronic-enhanced silver sulfadiazine topical dressing to provide antimicrobial protection to the wound and topical petrolatum-based ointment to maintain moist environment for the wound and the periwound. Our team also gave Ceftaroline, a cephalosporin for serious infections of the skin and tissues below the skin, intravenously. Result: One day after the surgical procedure, the wound dimensi...

International Journal Of Medical Science And Clinical Research Studies, Feb 22, 2023

Introduction: Scarring happens after trauma, injury or surgery to any tissue or organ ... more Introduction: Scarring happens after trauma, injury or surgery to any tissue or organ in the body. Disturbing perceptions like pain, itchiness or tenderness from one perspective, and functional limitations in the form of contractures on the other, are ramification of problematic scars. In addition, scar esthetics can also have a negative influence on psychosocial factors. Various treatment options described in the literature include chemical, physical, and surgical methods. The purpose of physical scar treatment is primarily focused on preventing inappropriate healing of the skin Methods: This literature review was compiled using information from numerous web databases, including NCBI, Google Scholar, Science Direct, and Pubmed. Data were analyzed. Results: Good wound management is to reduce the incidence of scar tissue in the wound. Embryonic scarless wound healing is a form of wound healing in the embryo and results in scarless wounds. Many in vivo studies have been carried out on several experimental animals, and the molecules that play a role are examined. Molecules that play a role in scarless and scarring wound healing are TGF-β1, 2, and 3. TGF-β1 and 2 play a role in the formation of scar tissue, while TGF-β3 plays a role in tissue regeneration. There is a hypothesis that TGF-β3 injected into the tissue will help wound healing and increase tissue regeneration so that scarless wound healing occurs.Conclusion:Molecules that play a role in scarless and scarring wound healing are TGF-β1, 2, and 3. TGF-β1 and2 play a role in the formation of scar tissue, while TGF-β3 plays a role in tissue regeneration. Scarless and scarring wound healing is not only based on the molecules that play a role but healing time and injured tissue also have an effect on wound formation. scarring and scarless wound healing can also occur in the same individual and the same individual tissue

Jurnal Plastik Rekonstruksi, 2020

Background : Arterio-venous malformations (AVMs) defined as high-flow vascular malformations of d... more Background : Arterio-venous malformations (AVMs) defined as high-flow vascular malformations of dysmorphic arterial and venous vessels. And connected directly to one another without an intervening capillary bed. The incidence is higher in females than male (3-5:1). Globally, there are only 5 cases of genital hemangiomas reported. Various treatment has been investigated, a recent topical treatment is the application of timolol. It has minimal adverse effects, easy administration, and good cosmetic outcomes. However, the effectiveness of timolol in vulvar cases remains unclear. Case Report : A one-year-old girl was brought by her mother with complaint of a lump in her child's genitals. The lump was appeared during the early days of her life and it was getting bigger gradually. A plastic surgeon performed excision and reconstruction procedure using the island abdominal flap technique. Discussion : Preserving vaginal function and perineal integrity is quite challenging, and cosmesis...

International Journal Of Medical Science And Clinical Research Studies, 2023

Obesity, defined as a condition with a body mass index (BMI) greater than 30 kg/m2, is a global e... more Obesity, defined as a condition with a body mass index (BMI) greater than 30 kg/m2, is a global epidemic. The rates of obesity have been rising in many countries, including the United States, Australia, China, and also in our country Indonesia. Bariatric surgery has seen a rise in rates worldwide in tandem with rising obesity rates in the world. Our literature review highlights the number of bariatric surgeries performed and the various procedures like gastric sleeve, Roux-en-Y gastric bypass, and gastric banding, available for patients. Furthermore, our review provides insights how combining bariatric surgery with body contouring procedures such as abdominoplasties, thighplasties, mastopexies, and brachyoplasties improves quality of life.

International Journal of Medical Science and Clinical Research Studies, 2023

Psoriasis is a chronic, immune-mediated inflammatory skin disorder that affects 2-3% of the popul... more Psoriasis is a chronic, immune-mediated inflammatory skin disorder that affects 2-3% of the population worldwide. Current therapies, including biologic agents, often have adverse effects and incomplete efficacy. Recent studies suggest that the PI3K/AKT/FOXO signalling cascade and interleukin-1 β play a crucial role in the pathogenesis of psoriasis. Hyperbaric oxygen therapy, a safe and well-tolerated procedure, has been suggested as a potential treatment for psoriasis due to its ability to increase tissue oxygenation and reduce inflammation. This review article summarizes the current understanding of the pathophysiology of psoriasis and the potential benefits of hyperbaric oxygen therapy as a treatment modality. The authors suggest that hyperbaric oxygen therapy may modulate the PI3K/AKT/FOXO signalling cascade, reduce interleukin-1 β levels, and improve skin oxygenation, leading to the attenuation of psoriatic plaques. Further clinical studies are needed to confirm the safety and efficacy of hyperbaric oxygen therapy in psoriasis treatment.

International Journal Of Medical Science And Clinical Research Studies, Mar 21, 2023

Diabetes is a metabolic disease characterized by hyperglycemia caused by a disruption in insulin ... more Diabetes is a metabolic disease characterized by hyperglycemia caused by a disruption in insulin secretion, insulin function, or both. An individual with diabetes have a greater likelihood to develop chronic non-healing wounds, and if untreated, various chronic complications are associated with psychiatric stress and depression. In diabetic wounds, the inflammatory phase becomes persistent and excessive with impaired cell proliferation and greater risk of infection. Several studies have shown that metformin has potential effect for diabetic wound healing. Here, we reported a case of diabetic wound in East Jangkat, a rural area in Indonesia, with pre-morbid type 2 diabetes mellitus and obesity class II with a deeper discussion about the potential effect of metformin for wound healing in diabetic ulcers.

International Journal Of Medical Science And Clinical Research Studies, Jan 31, 2023

The objective of this study was to compare the advantages and disadvantages of patients undergoin... more The objective of this study was to compare the advantages and disadvantages of patients undergoing either immediate or delayed breast reconstruction after mastectomy. This review was compiled using information from numerous web databases. Scientific articles were selected based on the inclusion criteria. Data were collected, organized, and summarized.
Mastectomy or breast removal is frequently performed as part of breast cancer treatment. Psychological issues following a mastectomy may get better for some patients after breast reconstruction. The most common type is immediate reconstruction, which preferably uses a nipple-sparing or skin-sparing mastectomy and implant-based reconstruction (but can also be autologous reconstruction). Delayed reconstruction is often performed using autologous tissue flaps or implant-based using either the definitive implant or temporary expanders. Immediate reconstruction creates better cosmetic outcomes, shorter overall costs, quicker recovery, higher quality of life, and increases the psychological well-being of patients. Besides, delayed reconstruction is a beneficial option for post-mastectomy radiation therapy (PMRT) cases and reduced the incidence of postoperative complications than immediate reconstruction.

International Journal Of Medical Science And Clinical Research Studies, Jul 12, 2022

Burn scars are associated with significant morbidity ranging from pigmentation, pruritus, pain, c... more Burn scars are associated with significant morbidity ranging from pigmentation, pruritus, pain, contractures and disfigurement to psychosocial impairment. Newer and advanced therapies for the treatment of burn scars have been developed, including lasers, and other topical treatments
An asian woman with history of having hypertrophic scar arising from the edges of previous skin graft for her second degree of burns. We performed contact-mode long pulsed 1064 nm Nd:YAG laser treatment in combination with topical tretinoin and hydroquinone. Ten months after initial combination treatment, the scar showed improvement in term of colour, contour, and consistency.
Burn scars have tendency to enlarge, hypertrophic and become keloids. Long pulsed 1064 nm Nd:YAG laser helps to reduce hypervascularization that usually found in hypertrophic scars or even keloid. Tretinoin is a derivate of vitamin A which has many different mechanisms in wound healing enhancement. Hydroquinone inhibits melanogenesis and plays role in maintaining pH level in wound healing process.
Burn scar responded well to long pulsed 1064 nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser treatment. A combination therapy with topical tretinoin and hydroquinone improved the burn scar in term of better color, contour and consistency.

International Journal Of Medical Science And Clinical Research Studies

Snake bite is common condition that lead to great consequence in the rural area of tropical count... more Snake bite is common condition that lead to great consequence in the rural area of tropical country. Although snakebite is treatable, WHO listed snakebite as Neglected Tropical Disease. Epidemiology data of snakebite not known exactly, the real data may be higher than data inscribed. Both venomous and non-venomous snake are can lead to fatal condition and make the victim consequences morbidity and mortality. Non-venomous snakebite also have potential risk of infection, coagulopathy, and traumatic feelings. Prognosis affected by many factors from snake venom, the victim, and environment that led to delayed medical treatment. Here, we report a case of neglected non-venomous snakebite wound that lead to severe infection of the limb.

Open Access Macedonian Journal of Medical Sciences, Feb 12, 2021

BACKGROUND: We investigated the epidemiology and the knowledge of first aid regarding to burns in... more BACKGROUND: We investigated the epidemiology and the knowledge of first aid regarding to burns in the rural area of Kulon Progo, located in Indonesia. Although 44% of Indonesia's population resides in rural areas, data of burn in Indonesia are very limited to national referral centers located in Indonesia's largest cities. We also surveyed the patients and families of these burn patients to try to understand their knowledge on the first aid of burns. AIM: We wanted to explore and discover what myths and misperceptions existed in rural communities. MATERIALS AND METHODS: A retrospective study analyzing the medical records of patients with burns admitted to two of Kulon Progo's largest referral hospitals between January 2018 and December 2019. A survey was distributed to the patients and their families regarding their knowledge on the first aid of burns. We wanted to analyze if certain groups of the population were more at risk for specific types of burn etiologies, the correlation between burn etiology and length of stay, the correlation between total body surface area (TBSA) of burns and length of stay in the hospital, and the correlation between education level of survey participants' and their knowledge of first aid of burns. RESULTS: A total of 115 patients were reviewed in this study. The highest proportion of total burn injuries occurred in the age group of 1-14 years old (38%). The major etiology of all burn cases were caused by scald (54%). Housewives and children were at a higher risk for scalds and laborers were at a higher risk for electrical and chemical burns (p = 0.001). There was no significant correlation between etiology and length of stay (p = 0.29). There was a statistically significant correlation between the TBSA and the length of hospital stay (p = 0.0001). The majority of survey respondents (66%) had poor knowledge on the first aid of burns. There was no significant correlation between education level and knowledge of first aid of burns (p = 0.07547). CONCLUSIONS: Children, laborers, and housewives have a significant risk of suffering from a burn injury. A majority of people still have poor knowledge on the first aid of burns. There was no correlation between education levels and knowledge of first aid burns.

International journal of medical science and clinical research studies, May 31, 2023

Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. ... more Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. hominid. Having scabies infestation coexisting in the same human body with a wound potentially lead to delayed wound healing. We constituted this literature review discussing wound healing in relation woth immunological state and oxidative stress in scabies infestation using information from literatures obtained from Google Scholar and PubMed. The immune response to scabies infection involves multiple layers of defense mechanisms, including the skin's defense mechanisms, T-cells, keratinocytes, and cytokines. Scabies mites can trigger upregulation of pro-inflammatory cytokines interleukins-1α (IL-1α) and interleukins-1β (IL-1β), which play a critical role in the early phases of wound healing by promoting the recruitment of immune cells and stimulating the production of growth factors and extracellular matrix proteins. Scabies mite infestation also triggers a sustained release of reactive oxygen species (ROS) from neutrophils which later becomes an oxidative stress leading to delayed healing and chronic inflammation. Topical treatment for scabies usually involves pesticide substances which, despite its therapeutic effect, have side effect of triggering ROS production. Comprehending the immunological state and oxidative stress in scabies infestation is essential in planning proper management for every wound with scabies comorbidity.

Zenodo (CERN European Organization for Nuclear Research), May 30, 2023

Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. ... more Scabies is a highly contagious skin disease caused by the human itch mite Sarcoptes scabiei var. hominid. Having scabies infestation coexisting in the same human body with a wound potentially lead to delayed wound healing. We constituted this literature review discussing wound healing in relation woth immunological state and oxidative stress in scabies infestation using information from literatures obtained from Google Scholar and PubMed. The immune response to scabies infection involves multiple layers of defense mechanisms, including the skin's defense mechanisms, T-cells, keratinocytes, and cytokines. Scabies mites can trigger upregulation of pro-inflammatory cytokines interleukins-1α (IL-1α) and interleukins-1β (IL-1β), which play a critical role in the early phases of wound healing by promoting the recruitment of immune cells and stimulating the production of growth factors and extracellular matrix proteins. Scabies mite infestation also triggers a sustained release of reactive oxygen species (ROS) from neutrophils which later becomes an oxidative stress leading to delayed healing and chronic inflammation. Topical treatment for scabies usually involves pesticide substances which, despite its therapeutic effect, have side effect of triggering ROS production. Comprehending the immunological state and oxidative stress in scabies infestation is essential in planning proper management for every wound with scabies comorbidity.

Zenodo (CERN European Organization for Nuclear Research), May 26, 2023

Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the intera... more Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the interaction between the innate and adaptive immune systems. The release of antimicrobial peptides (AMPs) by keratinocytes, particularly LL-37 peptides, plays a crucial role in the initiation of psoriatic inflammation. The activation of dendritic cells and distinct T-cell subsets, particularly Th1 and Th17, leads to the formation of scaly plaques in psoriasis. Although most cases are treated with topical or systemic medications, severe forms such as pustular psoriasis and psoriatic arthritis may require surgical management. Surgical procedures aim to relieve symptoms, improve function, and minimize scarring and cosmetic deformities. However, psoriatic patients are at higher risk of post-surgical infections and surgical stress may trigger psoriatic flare-ups. Thus, meticulous post-surgical wound care and psychological support are essential for optimal outcomes.

International Journal Of Medical Science And Clinical Research Studies

Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the intera... more Psoriasis is a chronic inflammatory skin disease with a complex pathogenesis involving the interaction between the innate and adaptive immune systems. The release of antimicrobial peptides (AMPs) by keratinocytes, particularly LL-37 peptides, plays a crucial role in the initiation of psoriatic inflammation. The activation of dendritic cells and distinct T-cell subsets, particularly Th1 and Th17, leads to the formation of scaly plaques in psoriasis. Although most cases are treated with topical or systemic medications, severe forms such as pustular psoriasis and psoriatic arthritis may require surgical management. Surgical procedures aim to relieve symptoms, improve function, and minimize scarring and cosmetic deformities. However, psoriatic patients are at higher risk of post-surgical infections and surgical stress may trigger psoriatic flare-ups. Thus, meticulous post-surgical wound care and psychological support are essential for optimal outcomes.

Indonesia Journal of Biomedical Science

Background:Capillary malformations (CMs) and Lymphatic malformation (LMs) are vascular malformati... more Background:Capillary malformations (CMs) and Lymphatic malformation (LMs) are vascular malformations that share a common tendency to cause soft and hard tissue hyperthropy, expressed in the three dimensions of the space. Although middle third of the face is the most commonly involved area, with a predominance of upper lip, the lower lip sometimes involved in some cases too. Vascular malformations of the lip often require reconstructive surgery with meticulous attention to both aesthetic and functional purposes. The lip reconstructive rule of thirds suggests that lower lip defects involving 1/3-2/3 total lip width require closure with lip switch or local advancement flap techniques (Karapandzic, Abbe, or Estlander).Case Description: 36 years old woman with bluish tumor lesion on lower lip since childhood, came to our clinic with history of  small lesion enlarging slowly, bluish in color, elastic in palpation, no bruit in auscultation. She had underwent surgery to reduce the size of ...

International Journal of Medical Science and Clinical Research Studies, 2023

Trichoepithelioma is a rare benign tumor, predominantly found on the face and scalp, with an uncl... more Trichoepithelioma is a rare benign tumor, predominantly found on the face and scalp, with an unclear prevalence in general population. Low incidence and lack of evidences, made trichoepithelioma management still a controversial domain in dermatology. Case: This study presented a 31-year-old woman with extensive trichoepithelioma on her nose, who underwent surgical excision and full-thickness skin grafting Result: Patient showed satisfaction with favorable aesthetic result and the consequent improvement in quality of her daily life. Discussion: Nasal intricate anatomy poses specific challenges in managing tumor like trichoepithelioma, emphasizing the importance of careful surgical planning. Surgical excision, Mohs surgery, and laser ablation are viable options, while non-surgical treatments such as topical therapies and cryotherapy are effective for superficial lesions. Patient satisfaction and quality of life are essential considerations, requiring open communication and psychological support. Emerging techniques, including advanced imaging, 3D bioprinting, and targeted molecular therapies, hold promise for optimizing trichoepithelioma management. Personalized approaches based on genetic profiling and collaborative research efforts are avenues for future exploration. Conclusion: Surgical management of trichoepithelioma on the nose, while challenging due to aesthetic concerns, can yield favorable outcomes. The approach to trichoepithelioma management should consider lesion size, surgical and non-surgical options and preference of the patient. Proper excision and meticulous skin grafting may provide aesthetically pleasant result. Personalized care, including psychological support, is crucial for post-surgery patient satisfaction. Multidisciplinary collaboration optimizes patient care in these unique cases.

International Journal of Medical Science and CLinical Research Studies, 2023

An episiotomy is a surgical incision in the perineum to facilitate the baby's head during deliver... more An episiotomy is a surgical incision in the perineum to facilitate the baby's head during delivery. Physicians or midwives may use this procedure if he/she finds out the tissue around the vaginal opening begins tearing or does not seem to be stretching enough to allow the baby to be delivered. With an increasing trend for hospital births and for physicians to get involved in the normal uncomplicated birth process, there was rise in the number of episiotomies. After the baby is delivered through the extended vaginal opening, the area is applied with local anesthetic agent and incision is repaired with sutures. Our study reviewed the development in the past twenty years regarding episiotomy wound closure methods, and discovered that continuous sutures for episiotomy or perineal repair have clinical advantages in term of faster and better wound healing, more favorable scarring, shorter post-procedural pain, more rapid resumption of sexual activity, lower incidence of urinary incontinence, compared to interrupted sutures. They were also beneficial in term of less consumption of suture materials. In determining suture materials, clinicians should strongly consider the tear severity, tissue characteristics, as well as the desired aesthetic outcome.

International Journal of Medical Science and Clinical Research Studies, 2023

Wound healing is a complex process critical for tissue repair post-injury. Botanicals, renowned i... more Wound healing is a complex process critical for tissue repair post-injury. Botanicals, renowned in traditional medicine, hold potential in wound healing due to their bioactive compounds. Etlingera elatior, a Zingiberaceae family member, is attracting attention for its diverse medicinal properties. Indigenous to Southeast Asia, it has been traditionally used for wound care, attributed to its anti-inflammatory, antioxidant, and antimicrobial effects. Recent scientific investigations highlight its ability to promote tissue repair, diminish inflammation, and counteract oxidative stress. These findings position Etlingera elatior as a promising candidate for wound healing management, particularly in plastic surgery. However, its clinical translation faces challenges, including limited clinical trials and mechanistic understanding, necessitating standardized extraction methods and regulatory approval. Bridging the gap between botanical therapies and clinical use requires robust clinical trials, mechanistic studies, and formulation optimization. Collaboration among researchers, clinicians, and regulators is pivotal in realizing Etlingera elatior's wound healing potential.

International Journal of Medical Science and Clinical Research Studies, 2023

Diabetic foot ulcers (DFUs) represent a significant health concern linked to poorly managed diabe... more Diabetic foot ulcers (DFUs) represent a significant health concern linked to poorly managed diabetes, affecting 19% to 34% of diabetic individuals and resulting in impaired functionality, infections, hospitalization, and the potential for amputations or mortality. Effective management involves addressing hyperglycemia, risk factors, and utilizing classification systems like SINBAD and IDSA/IWGDF for treatment. Skin grafting techniques such as split-thickness (STSG) and full-thickness (FTSG) grafts offer effective wound closure options. We acknowledged management for diabetic foot ulcers (DFUs) include autografts, cadaveric allografts, xenografts, and synthetic skin substitutes with natural polymers. Advanced techniques encompass biomaterials, nanobiomaterials, endothelial progenitor cells, and tissue engineering, while cellular therapies like mesenchymal stem cells (MSCs) show promise when properly activated. Innovations in DFU management encompass 3D bioprinting, nanotechnology, gene therapy, and photobiomodulation therapy. Positive clinical outcomes from skin grafting, including acellular fish skin (AFS) grafts, are observed, although challenges like graft rejection and limited technology awareness persist. Further research is essential to seamlessly integrate these advancements into DFU management for enhanced outcomes.

International Journal of Medical Science and Clinical Research Studies, 2023

Pediatric surgical wound care is a critical aspect of medical practice, necessitating innovative ... more Pediatric surgical wound care is a critical aspect of medical practice, necessitating innovative approaches to optimize healing and minimize complications. Platelet-rich plasma (PRP) therapy has emerged as a promising intervention for enhancing wound healing in pediatric patients. This review comprehensively evaluates the efficacy, underlying mechanisms, and challenges associated with platelet-rich plasma (PRP) therapy in the context of pediatric surgical wounds. Platelet-rich plasma (PRP), a biologic concentrate enriched with growth factors and cytokines, plays a pivotal role in wound healing by promoting cell proliferation, differentiation, and tissue regeneration. This article explores the mechanisms of action of this therapy in detail, focusing on its immunomodulatory effects and interaction with growth factors, and highlighting the significance of factors influencing platelet-rich plasma (PRP) efficacy, This article also gives examples of platelet-rich plasma (PRP) therapy in various pediatric surgical procedures, summarizes outcomes from clinical studies and trials, and addresses safety concerns and potential adverse effects associated with platelet-rich plasma (PRP) therapy in pediatric surgical wound management. In conclusion, this review underscores the potential of platelet-rich plasma (PRP) therapy as an adjunctive treatment in pediatric surgical wound care. By elucidating its mechanisms, clinical efficacy, and challenges, the review provides insights for clinicians and researchers to guide evidence-based practice. Recommendations for future research and the integration of platelet-rich plasma (PRP) therapy into clinical guidelines emphasize the importance of refining protocols, ensuring cost-effectiveness, and adhering to ethical standards in pediatric surgical wound care.

International Journal Of Medical Science And Clinical Research Studies

Introduction: Chemical burns are an uncommon form of burn injury, accounting for 2.1% to 6.5% of ... more Introduction: Chemical burns are an uncommon form of burn injury, accounting for 2.1% to 6.5% of all burn centre admissions. We presented one rare case of a second degree chemical burn due to successive contacts of acidic wart removal solution and paint mixture solution. Case: A 38-year-old male with chemical burn on both feet due to reckless usage of a self-purchased wart removal solution, and accidental contact with paint mixture solution. Our surgeon author diagnosed a superficial partial thickness (second-degree) chemical burn on this patient, and performed surgical debridement followed by hyaluronic-enhanced silver sulfadiazine topical dressing to provide antimicrobial protection to the wound and topical petrolatum-based ointment to maintain moist environment for the wound and the periwound. Our team also gave Ceftaroline, a cephalosporin for serious infections of the skin and tissues below the skin, intravenously. Result: One day after the surgical procedure, the wound dimensi...

International Journal Of Medical Science And Clinical Research Studies, Feb 22, 2023

Introduction: Scarring happens after trauma, injury or surgery to any tissue or organ ... more Introduction: Scarring happens after trauma, injury or surgery to any tissue or organ in the body. Disturbing perceptions like pain, itchiness or tenderness from one perspective, and functional limitations in the form of contractures on the other, are ramification of problematic scars. In addition, scar esthetics can also have a negative influence on psychosocial factors. Various treatment options described in the literature include chemical, physical, and surgical methods. The purpose of physical scar treatment is primarily focused on preventing inappropriate healing of the skin Methods: This literature review was compiled using information from numerous web databases, including NCBI, Google Scholar, Science Direct, and Pubmed. Data were analyzed. Results: Good wound management is to reduce the incidence of scar tissue in the wound. Embryonic scarless wound healing is a form of wound healing in the embryo and results in scarless wounds. Many in vivo studies have been carried out on several experimental animals, and the molecules that play a role are examined. Molecules that play a role in scarless and scarring wound healing are TGF-β1, 2, and 3. TGF-β1 and 2 play a role in the formation of scar tissue, while TGF-β3 plays a role in tissue regeneration. There is a hypothesis that TGF-β3 injected into the tissue will help wound healing and increase tissue regeneration so that scarless wound healing occurs.Conclusion:Molecules that play a role in scarless and scarring wound healing are TGF-β1, 2, and 3. TGF-β1 and2 play a role in the formation of scar tissue, while TGF-β3 plays a role in tissue regeneration. Scarless and scarring wound healing is not only based on the molecules that play a role but healing time and injured tissue also have an effect on wound formation. scarring and scarless wound healing can also occur in the same individual and the same individual tissue

Jurnal Plastik Rekonstruksi, 2020

Background : Arterio-venous malformations (AVMs) defined as high-flow vascular malformations of d... more Background : Arterio-venous malformations (AVMs) defined as high-flow vascular malformations of dysmorphic arterial and venous vessels. And connected directly to one another without an intervening capillary bed. The incidence is higher in females than male (3-5:1). Globally, there are only 5 cases of genital hemangiomas reported. Various treatment has been investigated, a recent topical treatment is the application of timolol. It has minimal adverse effects, easy administration, and good cosmetic outcomes. However, the effectiveness of timolol in vulvar cases remains unclear. Case Report : A one-year-old girl was brought by her mother with complaint of a lump in her child's genitals. The lump was appeared during the early days of her life and it was getting bigger gradually. A plastic surgeon performed excision and reconstruction procedure using the island abdominal flap technique. Discussion : Preserving vaginal function and perineal integrity is quite challenging, and cosmesis...

International Journal Of Medical Science And Clinical Research Studies, 2023

Obesity, defined as a condition with a body mass index (BMI) greater than 30 kg/m2, is a global e... more Obesity, defined as a condition with a body mass index (BMI) greater than 30 kg/m2, is a global epidemic. The rates of obesity have been rising in many countries, including the United States, Australia, China, and also in our country Indonesia. Bariatric surgery has seen a rise in rates worldwide in tandem with rising obesity rates in the world. Our literature review highlights the number of bariatric surgeries performed and the various procedures like gastric sleeve, Roux-en-Y gastric bypass, and gastric banding, available for patients. Furthermore, our review provides insights how combining bariatric surgery with body contouring procedures such as abdominoplasties, thighplasties, mastopexies, and brachyoplasties improves quality of life.

International Journal of Medical Science and Clinical Research Studies, 2023

Psoriasis is a chronic, immune-mediated inflammatory skin disorder that affects 2-3% of the popul... more Psoriasis is a chronic, immune-mediated inflammatory skin disorder that affects 2-3% of the population worldwide. Current therapies, including biologic agents, often have adverse effects and incomplete efficacy. Recent studies suggest that the PI3K/AKT/FOXO signalling cascade and interleukin-1 β play a crucial role in the pathogenesis of psoriasis. Hyperbaric oxygen therapy, a safe and well-tolerated procedure, has been suggested as a potential treatment for psoriasis due to its ability to increase tissue oxygenation and reduce inflammation. This review article summarizes the current understanding of the pathophysiology of psoriasis and the potential benefits of hyperbaric oxygen therapy as a treatment modality. The authors suggest that hyperbaric oxygen therapy may modulate the PI3K/AKT/FOXO signalling cascade, reduce interleukin-1 β levels, and improve skin oxygenation, leading to the attenuation of psoriatic plaques. Further clinical studies are needed to confirm the safety and efficacy of hyperbaric oxygen therapy in psoriasis treatment.

International Journal Of Medical Science And Clinical Research Studies, Mar 21, 2023

Diabetes is a metabolic disease characterized by hyperglycemia caused by a disruption in insulin ... more Diabetes is a metabolic disease characterized by hyperglycemia caused by a disruption in insulin secretion, insulin function, or both. An individual with diabetes have a greater likelihood to develop chronic non-healing wounds, and if untreated, various chronic complications are associated with psychiatric stress and depression. In diabetic wounds, the inflammatory phase becomes persistent and excessive with impaired cell proliferation and greater risk of infection. Several studies have shown that metformin has potential effect for diabetic wound healing. Here, we reported a case of diabetic wound in East Jangkat, a rural area in Indonesia, with pre-morbid type 2 diabetes mellitus and obesity class II with a deeper discussion about the potential effect of metformin for wound healing in diabetic ulcers.

International Journal Of Medical Science And Clinical Research Studies, Jan 31, 2023

The objective of this study was to compare the advantages and disadvantages of patients undergoin... more The objective of this study was to compare the advantages and disadvantages of patients undergoing either immediate or delayed breast reconstruction after mastectomy. This review was compiled using information from numerous web databases. Scientific articles were selected based on the inclusion criteria. Data were collected, organized, and summarized.
Mastectomy or breast removal is frequently performed as part of breast cancer treatment. Psychological issues following a mastectomy may get better for some patients after breast reconstruction. The most common type is immediate reconstruction, which preferably uses a nipple-sparing or skin-sparing mastectomy and implant-based reconstruction (but can also be autologous reconstruction). Delayed reconstruction is often performed using autologous tissue flaps or implant-based using either the definitive implant or temporary expanders. Immediate reconstruction creates better cosmetic outcomes, shorter overall costs, quicker recovery, higher quality of life, and increases the psychological well-being of patients. Besides, delayed reconstruction is a beneficial option for post-mastectomy radiation therapy (PMRT) cases and reduced the incidence of postoperative complications than immediate reconstruction.

International Journal Of Medical Science And Clinical Research Studies, Jul 12, 2022

Burn scars are associated with significant morbidity ranging from pigmentation, pruritus, pain, c... more Burn scars are associated with significant morbidity ranging from pigmentation, pruritus, pain, contractures and disfigurement to psychosocial impairment. Newer and advanced therapies for the treatment of burn scars have been developed, including lasers, and other topical treatments
An asian woman with history of having hypertrophic scar arising from the edges of previous skin graft for her second degree of burns. We performed contact-mode long pulsed 1064 nm Nd:YAG laser treatment in combination with topical tretinoin and hydroquinone. Ten months after initial combination treatment, the scar showed improvement in term of colour, contour, and consistency.
Burn scars have tendency to enlarge, hypertrophic and become keloids. Long pulsed 1064 nm Nd:YAG laser helps to reduce hypervascularization that usually found in hypertrophic scars or even keloid. Tretinoin is a derivate of vitamin A which has many different mechanisms in wound healing enhancement. Hydroquinone inhibits melanogenesis and plays role in maintaining pH level in wound healing process.
Burn scar responded well to long pulsed 1064 nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser treatment. A combination therapy with topical tretinoin and hydroquinone improved the burn scar in term of better color, contour and consistency.

International Journal Of Medical Science And Clinical Research Studies

Snake bite is common condition that lead to great consequence in the rural area of tropical count... more Snake bite is common condition that lead to great consequence in the rural area of tropical country. Although snakebite is treatable, WHO listed snakebite as Neglected Tropical Disease. Epidemiology data of snakebite not known exactly, the real data may be higher than data inscribed. Both venomous and non-venomous snake are can lead to fatal condition and make the victim consequences morbidity and mortality. Non-venomous snakebite also have potential risk of infection, coagulopathy, and traumatic feelings. Prognosis affected by many factors from snake venom, the victim, and environment that led to delayed medical treatment. Here, we report a case of neglected non-venomous snakebite wound that lead to severe infection of the limb.