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All Journal Universa Medicina Indonesian Journal of Biomedicine and Clinical Sciences
Sabudi, I Made Nugraha Gunamanta
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Risk factors of doxorubicin-induced cardiomyopathy in non-muscle- invasive bladder cancer Sabudi, I Made Nugraha Gunamanta; Hendri, Ahmad Zulfan
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.297-303

Abstract

BackgroundDoxorubicin is an anthracycline antibiotic widely used as a chemotherapeutic agent to treat solid tumors and hematologic malignancies. Bladder cancer is the second most common genitourinary malignancy and can be classified into muscle-invasive bladder cancer and non-muscle-invasive bladder cancer (NMIBC). In Indonesia, NMIBC is treated by doxorubicin instillation. Several risk factors have been suggested to be associated with doxorubicin-induced cardiomyopathy, but on their quantitative effects no consensus has as yet been reached. This study aimed to determine the risk factors of doxorubicin-induced cardiomyopathy in NMIBC patients with intravesical doxorubicin instillation. MethodsA cross-sectional study was conducted involving 74 NMIBC patients who received local treatment by doxorubicin instillation after transurethral resection of bladder tumor (TURBT). Data were collected on the risk factors that may be favorable to doxorubicin-induced cardiomyopathy, namely age, sex, hypertension, type 2 diabetes mellitus, smoking, and NMIBC risk classification. The dependent variable was cardiomyopathy with decreasing left ventricular ejection fraction (LVEF) below 50 %. Multiple logistic regression was used to analyze the data. ResultsThe prevalence of cardiomyopathy was 6.75% (5/74). Type 2 diabetes mellitus was a significant risk factor for doxorubicin-induced cardiomyopathy among our subjects (aOR=34.30;95% C.I.:1.36-865-86;p=0.032). In contrast, age, sex, risk classification, hypertension, and smoking were nonsignificant predictors for doxorubicin-induced cardiomyopathy (p>0.05). ConclusionThis study demonstrated that type 2 diabetes mellitus increased the risk of cardiomyopathy in doxorubicin users among patients with NMIBC. More research is necessary regarding the mechanisms underlying type 2 diabetes mellitus as a risk factor for doxorubicin-induced cardiomyopathy.
Urethroscopy evacuation of glue stick polyembolokoilomania: a case report Sabudi, I Made Nugraha Gunamanta; Irzan, Muhammad Anwar; Ghinorawa, Tanaya
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 1 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i1.17134

Abstract

Insertion of a foreign body is an uncommon case in the urology emergency. It was reported one of the abnormal habits called polyemobolokoilomania, which involves inserting strange things into the self-body orifice, especially the urethra in the urological case. A male 56 yo came with a history of inserting a glue stick on his external urethral orifice and complained of dysuria. By physical examination, palpated solid things 6 cm from the external urethral orifice. The patient then planned to undergo urethroscopy and found the glue stick along 27 cm. Urethroscopy successfully evacuated the whole glue stick, and a silicone catheter 18 Fr was applied to monitor the urine. The next 2 wk, the indwelling catheter was removed, and the patient could normally urinate. Glue stick insertion is one of the things that is commonly inserted by polyembolokoilomania, or the act of insertion a foreign body into a human orifice. Psychological and psychiatric aspects also need to be evaluated, because the patient could have mental health issues that need to be treated to prevent recurrent habits in the future. Physical examination of foreign bodies could be found when palpated along the penis. Further diagnostic tools like BNO could be conducted if there was no clear information from history taking (patient dishonest or unable to communicate) and in doubt by physical examination. The approach to evacuation could be varied, it could be evacuated by a milking procedure, endourology using a urethroscope, or open surgery. Insertion of strange things or polyembolokoilomania was an uncommon case in a urology emergency setting. The treatment focuses on evacuating the foreign body, and the patient can urinate normally. Psychological and psychiatric aspects also need to be followed up to prevent recurrent habits as a risk factor for repeated cases.
Co-Authors . Zulfan Irzan, Muhammad Anwar Tanaya Ghinorawa