Predictive accuracy of blood inflammatory markers on COVID-19 mortality

Background: The impact of COVID-19 may be more severe in developing countries. Our study aims to analyze the accuracy of several inflammatory biomarkers in predicting COVID-19 mortality, providing information about the most suitable markers for developing countries. Methods: A retrospective cohort study was conducted at Dr. Soetomo General Hospital, Indonesia, from March to June 2020. White Blood Cells (WBC) count, Neutrophil-Lymphocyte Ratio (NLR), Procalcitonin (PCT), D-Dimer, and C-Reactive Protein (CRP) have been collected from the electronic medical records. We performed survival analysis to provide the hazard ratio and Receiver Operating Characteristic (ROC) curve analysis to test for accuracy for each parameter. Results: A total of 423 patients who met the criteria for participating had a median age of 54 (IQR 45-61) years. Patients in the death group are characterized by older age and shorter length of hospitalization. The WBC, NLR, PCT, D-Dimer, and CRP are found significantly higher in the death group (P=0.000). The WBC, NLR, PCT, D-Dimer, and CRP have an Area Under the Curve (AUC) of 0.709, 0.773, 0.738, 0.721, and 0.769, respectively moderate accuracy in predicting COVID-19 patient mortality. We found that NLR is significantly more accurate than the age parameter (Z=3.527; P=0.000) but has equal accuracy with other laboratory parameters.  Conclusions: Since NLR obtained the highest accuracy, we still recommend routine complete blood count tests as prognostic biomarkers with the highest feasibility to be performed in developing countries

PERBANDINGAN NILAI DIAGNOSTIK HDL DENGAN RASIO KOLESTEROL TOTAL : HDL PADA PASIEN PJK

Latar belakang:Penyakit Jantung koroner adalah penyakit yang menyerang banyak penduduk di berbagai negara termasuk Indonesia. WHO pada tahun 2013 memperkirakan, penderita yang meninggal akibat PJK (Penyakit Jantung Koroner) akan meningkat sampai sebesar 23,3 juta jiwa pada tahun 2030. Di Indonesia sendiri, proporsi penderita PJK semakin meningkat dari tahun ke tahun. Terdapat beberapa faktor resiko yang menjadi penyebab dari penyakit PJK. Beberapa diantaranya adalah kadar kolesterol darah yang tinggi atau dikenal sebagai hiperkolesterolemia.Banyaknya jenis dari kolesterol seperti kolesterol total, HDL, LDL, rasio kolesterol total / HDL, dan lain sebagainya dapat digunakan sebagai indikator daam mendeteksi PJK. Pada penelitian ini peneliti akan mendeskripsikan apakah terdapat perbedaan antara penggunaan rasio kolesterol total / HDL dengan HDL saja pada pasien penderita PJK di RSUD Dr Soetomo Surabaya. Tujuan: menggambarkan profil lipid HDL dan rasio kolesterol total / HDL pada penderita PJK di RSUD Dr. Soetomo Surabaya, dan mengetahui ada tidaknya perbedaan antara nilai prediktif antara rasio kolesterol total/HDL dengan HDL saja. Metode: penelitian ini menggunakan metode Analitik retrospektif dengan menggunakan metode total sampling dari penderita penyakit jantung koroner di RSU Dr Soetomo Surabaya Bulan Januari-Maret 2014 dan dilakukan uji sign test untuk mengetahui signifikansinya dengan kriteria α: 0,05 dan CI sebesar 95%. Hasil: Dari penelitian ini dapat disimpulkan bahwa terdapat perbedaan yang bermakna antara rasio kolesterol total : HDL dengan HDL saja sebagai nilai prediktif dalam pendeteksi penyakit PJK (P = 0.04)

EKSPERIMENTASI MODEL PEMBELAJARAN NUMBERED HEADS TOGETHER PADA MATERI FUNGSI KOMPOSISI DI SMK NEGERI 4 PALANGKA RAYA

Pemecahan masalah merupakan salah satu kemampuan yang dibutuhkan dalam kehidupan sehari-hari. Kenyataan disekolah masih banyak siswa yang belum mampu memecahkan masalah khususnya masalah matematika. Faktor yang mempengaruhi rendahnya pemecahan masalah adalah pembelajaran yang diterapkan oleh guru kurang memberikan kesempatan kepada siswa untuk terlibat aktif dalam mengemukakan ide dan gagasan. Kondisi tersebut perlu diperbaiki dengan menerapkan suatu model pembelajaran yang membuat siswa lebih aktif yaitu model pembelajaran Numbered Heads Together yang menggunakan langkah pemecahan berdasarkan polya. Tujuan Penelitian ini sesuai dengan masalah di atas adalah untuk mengetahui Perbedaan Hasil Belajar Dengan Menggunakan Model Pembelajaran Numbered Heads Together Antara Kelas Kontrol Dengan Kelas Eksperimen Pada Materi Fungsi Komposisi di SMK Negeri 4 Palangka Raya. Pendekatan penelitian ini adalah kuantitatif, dengan jenis penelitian yang digunakan adalah pre-eksperimental. Desain yang digunakan pada penelitian ini adalah Pretest-Posttest Control Group Design. Data penelitian akan dianalisis dengan teknik Uji Mann Whitney U Test. Populasi dalam penelitian ini adalah seluruh siswa kelas XI Multimedia SMK Negeri 4 Palangka Raya tahun pelajaran 2018/2019 yang terdiri dari 3 kelas dengan jumlah 91 orang. Peneliti mengambil kelas XI Multimedia 3 yang berjumlah 19 siswa sebagai kelas eksperimen diberikan perlakuan pembelajaran Numbered Heads Together (NHT) dan Kelas XI Multimedia 2 yang berjumlah 11 siswa sebagai kelas kontrol diberikan perlakuan pembelajaran yang ada disekolahan. Kedua kelas dilakukan pretest yang sudah di uji coba melalui analisis butir soal yang telah di uji coba disekolahan lain, dimana soal pretest yang digunakan adalah butir soal yang valid. Dari skor pretest diperoleh rata-rata kelas eksperimen sebesar 5,94 dan rata-rata kelas kontrol sebesar 5,318. Setelah diuji diketahui bahwa data ada yang tidak memenuhi uji prasyarat yaitu pada data Posttest ada yang tidak mengikuti distribusi normal maka uji yang dilakukan menggunakan uji non parametrik yaitu uji Mann Whitney U test. Hasil analisis dengan uji Mann Whitney U test menunjukkan bahwa U_hitung= 37 ≤ U_tabel=65, sehingga diputuskan bahwa H0 ditolak dan H1 diterima. Artinya ada Perbedaan Hasil Belajar Dengan Menggunakan Model Pembelajaran Numbered Heads Together Antara Kelas Kontrol Dengan Kelas Eksperimen Pada Materi Fungsi Komposisi di SMK Negeri 4 Palangka Raya

THE PROFILE OF CORONARY HEART DISEASE PATIENTS IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA

Background: Coronary heart disease is a deadly disease for human. The incidence of coronary heart disease is different, so that this research reported the profile of coronary heart disease patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Objective: To analyze the profile of CHD patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from February to September 2018. Materials and Methods: A descriptive research based on the medical records. Results: There were 65 male patients and 20 female patients. There were 58% patients aged 50-60 years old, 24% patients aged more than 60 years old, and 18% patients are under 50 years old. The patients’ occupations were as follows: 42% civil servants, 36% private employees, 9% housewives, 5% retirees, 3% entrepreneurs, 1% for teacher, driver, fisherman, priest, and merchant. The complaints included chest pain (40%), shortness of breath (23.5%), PCI (4.6%), thump chest (1.2%), lower right abdominal pain (1.2%), right leg pain (1.2%), nausea (1.2%), vomitting (1.2%), cough (1.2%), dysentry (1.2%), and no complaint (23.5%). CHD patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia had the history of hypertension (30.6%), heart disease (22.6%), diabetes mellitus (21.9%), smoking (5.6%), COPD (0.8%), and no history of disease (12.9%). Sixty-one percent of the patients had blood sugar level of  ≥100 mg/dl, 19% patients had blood sugar level of <100 mg/dl, 20% patients did not have data. Conclusion: There were 85 patients, predominantly males of 50-60 years old. The most common occupation of the patients was civil servant and they came with major complaint of chest pain with the history of hypertension

Deaktivasi Katalis Konverter-Hidrogen Di Pabrik Urea Kaltim-3

<p>Di pabrik urea, konverter-hidrogen adalah satu reaktor yang berfungsi untuk mengkonversi hidrogen yang terikut dalam karbondioksida dengan cara mengoksidasi dengan udara, sehingga karbondioksida umpan reaktor urea itu hanya mengandung tidak lebih dari 100 ppm hidrogen. Konversi dilangsungkan pada tekanan 145 kg/cm2 dan suhu umpan reaktor 130 C, menggunakan katalis platinum berpenyangga alumina (0,3%Pt/Al2O3). Dalam dua tahun terakhir, terjadi kenaikan kandungan hidrogen dalam karbondioksida umpan konverter-hidrogen Kaltim-3 yang menyebabkan peningkatan temperatur keluaran konverter dari biasanya sekitar 152oC menjadi sekitar 190 C. Hasil analisis kadar Pt, luas permukaan katalis dan dispersi Pt terhadap katalis-baru dan katalis-terpakai menunjukkan bahwa katalis konverter-hidrogen Kaltim-3 telah terdeaktivasi. Oleh karena itu, pada kesempatan perbaikan-tahunan Juli 2006 yang lalu, katalis tersebut telah diganti dengan yang baru. Selain itu telah dilakukan pula perbaikan kondisi operasi di pabrik amoniak Kaltim-3, sehingga kadar H2 dalam aliran CO2 umpan pabrik urea Kaltim-3 menjadi normal kembali (0,4%). Dengan tindakan-tindakan tersebut, sejak Agustus 2006 yang lalu konverter hidrogen Kaltim-3 dapat beroperasi secara normal kembali. © 2007 BCREC UNDIP. All rights reserved.</p><p>[Presented at Symposium and Congress of MKICS 2007, 18-19 April 2007, Semarang, Indonesia]</p><p><strong>[How to Cite</strong>: A. Subekti, A.S. Arief, P. Praharso, S. Subagjo. (2007). Deaktivasi Katalis Konverter-Hidrogen Di Pabrik Urea Kaltim-3. <em>Bulletin of Chemical Reaction Engineering and Catalysis</em>, 2 (2-3): 52-55. <strong>doi:10.9767/bcrec.2.2-3.10.52-55</strong>]</p><p><strong>[How to Link/DOI</strong>: <a href="http://dx.doi.org/10.9767/bcrec.2.2-3.10.52-55" target="_self">http://dx.doi.org/10.9767/bcrec.2.2-3.10.52-55</a> ]</p><p> </p

Cardio-vocal Syndrome as a Complication Patient with Severe Mitral Regurgitation and Moderate Aortic Regurgitation with Pulmonary Hypertension

ABSTRACT  Hoarseness due to paralysis of vocal cord, as in Cardio-vocal syndrome, is caused by mechanical affection of left recurrent laryngeal nerve from enlarged cardiovascular structures. Mitral valve prolapse is rarely found to cause this syndrome. Case report presenting a 47 years old male visited the outpatient department with a clinical history of dyspnea and hoarseness since a year ago. Physical examination revealed late systolic murmur in apex and low-grade diastolic murmur in right second intercostal space. Echocardiography confirmed severe mitral regurgitation due to flail anterior mitral valve leaflet with severe left atrium dilatation (9.0 cm) and moderate aortic regurgitation due to mal-coaptation of aortic valves. Laryngoscopy revealed an immobile left vocal cord. He underwent successful double valve replacement after three months follow up the patient showed improvement of hoarseness. The incidence of Cardio-vocal syndrome in mitral valve disease varies from 0.6% to 5%. In cases diagnosed with thoracic disease, paralysis of the left vocal cord was reported 1.75 times more frequent than the right side. The aim of this case report is we have to aware that Cardio-vocal syndrome is a rare cause of vocal cord paralysis and should be considered as a differential diagnosis of hoarseness, particularly if the patient has a cardiac history. Comprehensive evaluation and prompt treatment may allow reversal of the damage to left recurrent laryngeal nerve. Permanent nerve damage can occur due to late diagnosis. Keywords             : Cardio-vocal syndrome, Mitral regurgitation, Aortic RegurgitationCorrespondence   : [email protected]

Efficacy and Safety of Prophylactic-Dose Anticoagulation Therapy with Intermediate-Therapeutic Doses in Covid-19 Patients

Abstract Introduction: Coronavirus Disease-19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) was declared a worldwide pandemic on March 11, 2020 and globally, on April 29, 2022, there were 510,270,667 confirmed COVID-19 cases, including 6,233,526 deaths, reported to WHO. As of April 2022, the Government of the Republic of Indonesia has reported 4,249,323 confirmed cases of COVID-19. There have been 143,592 COVID-19-related deaths reported and 4,096,194 patients have recovered from the disease. COVID-19 is associated with a high risk of venous thromboembolism (VTE), however, to date, optimal prophylactic anticoagulant therapy remains uncertain and may depend on the severity of COVID-19. Objective: The aim of this study was to determine the difference in efficacy and safety in administering prophylactic doses with intermediate/therapeutic doses in confirmed COVID-19 patients. Results: This study used 6 studies that met the inclusion of differences in efficacy and safety in administering prophylactic doses with intermediate/therapeutic doses in confirmed COVID-19 patients. Conclusion: From 6 studies, there were 2 studies comparing anticoagulant prophylactic doses with intermediate doses and 4 studies comparing anticoagualnt prophylactic doses with therapeutic doses. In all studies, there were no significant differences in thromboembolic events or all-cause mortality in COVID-19 patients. The incidence of bleeding at the intermediate and therapeutic doses increased compared to the prophylactic dose, but the difference was not significant

THE PROFILE OF CORONARY HEART DISEASE PATIENTS IN DR SOETOMO GENERAL HOSPITAL

Abstract. Background: Coronary heart disease is a deadly disease for human. The incidence of coronary heart disease is different, so that this research reported the profile of coronary heart disease patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Objective: To analyze the profile of CHD patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from February to September 2018. Materials and Methods: A descriptive research based on the medical records. Results: There were 65 male patients and 20 female patients. There were 58% patients aged 50-60 years old, 24% patients aged more than 60 years old, and 18% patients are under 50 years old. The patients’ occupations were as follows: 42% civil servants, 36% private employees, 9% housewives, 5% retirees, 3% entrepreneurs, 1% for teacher, driver, fisherman, priest, and merchant. The complaints included chest pain (40%), shortness of breath (23.5%), PCI (4.6%), thump chest (1.2%), lower right abdominal pain (1.2%), right leg pain (1.2%), nausea (1.2%), vomitting (1.2%), cough (1.2%), dysentry (1.2%), and no complaint (23.5%). CHD patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia had the history of hypertension (30.6%), heart disease (22.6%), diabetes mellitus (21.9%), smoking (5.6%), COPD (0.8%), and no history of disease (12.9%). Sixty-one percent of the patients had blood sugar level of ≥100 mg/dl, 19% patients had blood sugar level of <100 mg/dl, 20% patients did not have data. Conclusion: There were 85 patients, predominantly males of 50-60 years old. The most common occupation of the patients was civil servant and they came with major complaint of chest pain with the history of hypertension

Endothelial dysfunction by brachial artery flow-mediated dilatation as predictor of major adverse cardiovascular event in acute coronary syndrome

Endothelial dysfunction (ED) is the earliest marker in the process of atherosclerosis formation and is thought to be a risk predictor of acute coronary syndrome&nbsp;&nbsp; &nbsp;(ACS) outcome. Our aim is to analyse the ED by brachial artery flow-mediated dilatation (FMD) as a predictor of major adverse cardiovascular event (MACE) in ACS patients. This is a prospective cohort study with consecutive sampling for ACS in a hospital at Indonesia in April-May, 2021. 69 patients who met the inclusion were examined for brachial artery FMD with value &lt;5% stated as ED. MACE was observed during in-hospital, 1 month, and 6 months after hospitalization, and analysed using bivariate analysis and multivariate logistic regression analysis. From bivariate analysis, significant result was found for FMD &lt;5% (RR 7,13; 95%CI=2,07-24,58; p=0.001) with 1 month of follow-up MACE and diabetes mellitus (RR 2,57; 95%CI=1,15-5,73; p=0,043) and FMD &lt;5% (RR=5,60; 95%CI=2,44-12,86; p&lt;0.001) with 6 months of follow-up MACE. In multivariate analysis, FMD &lt;5% was found as the most significant predictor of 1 month and 6 months follow-up MACE. ED by brachial artery FMD was an important independent predictor of the&nbsp; &nbsp;MACE during 1 month and 6 months follow-up after ACS and might be useful for risk stratification outcome