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Shock Management and Hemodynamic Monitoring of Severe Dengue with Fluid Overload: A Case Report Asbi, Shinta; Indra Ihsan; Rinang Mariko
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1105

Abstract

Background: Dengue shock syndrome (DSS) is a life-threatening complication of dengue infection characterized by plasma leakage, shock, and organ dysfunction. Fluid management is crucial in DSS, but fluid overload can lead to adverse outcomes. This case report highlights the challenges and strategies in managing DSS with fluid overload. Case presentation: An 8-year-old girl presented with severe dengue, DSS, encephalopathy, and fluid overload. She had a history of high fever, vomiting, and altered consciousness. Initial management focused on fluid resuscitation, but the patient developed signs of fluid overload. Hemodynamic monitoring using USCOM (Ultrasonic Cardiac Output Monitor) revealed low cardiac output and high systemic vascular resistance. Fluid restriction and inotropic support with epinephrine were initiated. The patient's condition gradually improved, and she was discharged after complete recovery. Conclusion: This case emphasizes the importance of early recognition and careful monitoring of fluid status in DSS. Hemodynamic monitoring tools like USCOM can aid in guiding fluid management and identifying complications like fluid overload. Prompt intervention with fluid restriction and inotropic support can improve outcomes in DSS patients with fluid overload.
Vascular Architecture Alterations Independent of Lipid Profiles: The Paradoxical Dissociation between Dyslipidemia and Carotid Intima-Media Thickness in Obese Adolescents Yenny Astari; Didik Hariyanto; Eka Agustia Rini; Eva Chundrayetti; Nice Rachmawati Masnadi; Anggia Perdana Harmen; Rinang Mariko
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1564

Abstract

Background: Adolescent obesity is a global epidemic that initiates subclinical atherosclerosis. While lipid profiles are traditional markers, their correlation with structural vascular changes in the pediatric population remains a subject of intense academic debate. This study evaluates the relationship between traditional lipid parameters and carotid intima-media thickness (CIMT) in obese high school students. Methods: An observational cross-sectional study was conducted between January 2025 and January 2026 involving 45 obese adolescents aged 15 to 18 years in Padang, Indonesia. Nutritional status was determined using the CDC 2000 growth charts, specifically targeting those with a body mass index at or above the 95th percentile. CIMT was measured via high-resolution B-mode ultrasonography. Lipid profiles, including total cholesterol, triglycerides, HDL, and LDL, were analyzed through laboratory testing. Statistical analysis utilized Fisher’s exact test through SPSS version 22. Results: The subjects, of whom 68.9 percent were female, had a median BMI of 29.34 ± 2.03 kg/m². Remarkably, 68.9 percent exhibited CIMT thickening above the 75th percentile. Bivariate analysis revealed no significant association between CIMT and total cholesterol (p=0.402), triglycerides (p=0.696), HDL (p=0.563), or LDL (p=1.000). Conclusion: Vascular remodeling in obese adolescents occurs independently of circulating lipid levels, suggesting that chronic inflammation may drive early atherosclerosis before clinical dislipidemia manifests.
Vascular Architecture Alterations Independent of Lipid Profiles: The Paradoxical Dissociation between Dyslipidemia and Carotid Intima-Media Thickness in Obese Adolescents Yenny Astari; Didik Hariyanto; Eka Agustia Rini; Eva Chundrayetti; Nice Rachmawati Masnadi; Anggia Perdana Harmen; Rinang Mariko
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1564

Abstract

Background: Adolescent obesity is a global epidemic that initiates subclinical atherosclerosis. While lipid profiles are traditional markers, their correlation with structural vascular changes in the pediatric population remains a subject of intense academic debate. This study evaluates the relationship between traditional lipid parameters and carotid intima-media thickness (CIMT) in obese high school students. Methods: An observational cross-sectional study was conducted between January 2025 and January 2026 involving 45 obese adolescents aged 15 to 18 years in Padang, Indonesia. Nutritional status was determined using the CDC 2000 growth charts, specifically targeting those with a body mass index at or above the 95th percentile. CIMT was measured via high-resolution B-mode ultrasonography. Lipid profiles, including total cholesterol, triglycerides, HDL, and LDL, were analyzed through laboratory testing. Statistical analysis utilized Fisher’s exact test through SPSS version 22. Results: The subjects, of whom 68.9 percent were female, had a median BMI of 29.34 ± 2.03 kg/m². Remarkably, 68.9 percent exhibited CIMT thickening above the 75th percentile. Bivariate analysis revealed no significant association between CIMT and total cholesterol (p=0.402), triglycerides (p=0.696), HDL (p=0.563), or LDL (p=1.000). Conclusion: Vascular remodeling in obese adolescents occurs independently of circulating lipid levels, suggesting that chronic inflammation may drive early atherosclerosis before clinical dislipidemia manifests.