Prothrombin Fragment 1.2 (F1.2) in Relation with Plasma Leakage Dan Thrombocytopenia in Dengue Infection

Latar belakang: Manifestasi klinis demam berdarah Dengue (DBD) adalah kebocoran plasma dan trombositopenia. Salah satu teori penyebab kedua hal tersebut adalah kadar trombin yang meningkat akibat aktivasi koagulasi. Kadar trombin dapat diwakili oleh kadar F1.2. Tujuan penelitian ini adalah untuk mengetahui hubungan antara kadar F1.2 dengan kebocoran plasma dan trombositopenia pada infeksi Dengue. Metode: Desain penelitian ini adalah potong lintang, mengggunakan plasma EDTA dari pasien terinfeksi virus Dengue. Subyek penelitian adalah 10 subyek dengan kebocoran plasma dan 10 subyek tanpa kebocoran plasma pada infeksi Dengue, 6 sampel berpasangan untuk perbandingan fase kritis dan fase konvalesen, 26 sampel untuk uji korelasi antara kadar F1.2 dengan jumlah trombosit. Hasil: Penelitian menunjukkan kadar F1.2 pada pasien terinfeksi virus Dengue dengan kebocoran plasma (rerata ± 2SD) 147,4 ± 105,82 pg/mL lebih tinggi secara bermakna dibanding tanpa kebocoran plasma 51,3 ±39,92 pg/mL. Kadar F1.2 pada fase kritis dengan median 186,3 (108,6-223,2) pg/mL lebih tinggi secara bermakna dibanding fase konvalesen 46,5 (27,4-51,9) pg/mL. Terdapat korelasi negatif yang bermakna dengan kekuatan sedang antara kadar F1.2 dengan jumlah trombosit, nilai r = - 0,609. Kesimpulan: Terdapat peningkatan aktivasi koagulasi yang ditunjukkan dengan peningkatan kadar F1.2 pada fase kritis, berkaitan dengan kebocoran plasma dan trombositopenia pada pasien terinfeksi virus Dengue. Kata kunci: infeksi Dengue, kebocoran plasma, trombin, fragmen protrombin (F1.2), trombositopenia Background: Clinical manifestations of Dengue hemorrhagic fever are plasma leakage and thrombocytopenia. Both manifestations are thought to be caused by an increased thrombin level due to activation of coagulation. The aim of this study is to look for any association between F1.2 level and plasma leakage and also between F1.2 level and thrombocytopenia in Dengue infected patients. Methods: This study used EDTA plasma from patients infected with Dengue virus. The study design was cross sectional. The thrombin level was represented by the prothrombin fragment 1.2 (F1.2) level. Twenty subjects were enrolled in this study, consisted of 10 subjects with plasma leakage and 10 without plasma leakage, 6 pairs of samples in critical phase and convalescent phase, 26 samples for correlation test between F1.2 level and platelet count. Results: In this study, it was found that the F1.2 level in patients with plasma leakage (mean ± 2 SD) 147.4 ± 105.82 pg/mL is significantly higher compared to patients without plasma leakage 51.3 ±39.92 pg/mL, and the F1.2 level in critical phase has a median of 186.3 (108.6-223.2) pg/mL which is significantly higher compared to convalescent phase 46.5(27.4-51.9) pg/mL. Also it was found that a medium negative correlation between F1.2 level and the thrombocyte count existed, r = - 0.609. Conclusion: The results of the study suggest that there was increased coagulation activation at critical phase in patients infected with Dengue virus associated with plasma leakage and thrombocytopenia

Harmonic Distortion Characteristics Generated by Heating Ventilation Air Conditioning System Case Study in PCR Laboratory

Good power quality is required in health facilities since the increasing use of microprocessor-based equipment. Poor power quality in the electric power system can cause medical equipment in health care centers to malfunction and give incorrect medical diagnoses. Since 2020 we are facing a new type of Virus (Covid-19), this virus requires special laboratory construction with specific air conditioning systems (temperature, humidity, and pressure) to process specimens. This paper presents measurement results of harmonic distortion characteristic by Variable Frequency Drive (VFD) of Heating Ventilation Air Conditioning (HVAC) system in PCR Laboratory at Clinic A. The VFD in this system is used to adjust the rotation of the exhaust fan and outdoor unit. The measured voltage, current and power are used to assess power quality. The main power quality problems found in medical facilities are voltage flicker, neutral currents, and total harmonic distortion (THD) values. The measurement of total harmonic distortion (THD) is used to find the source of the harmonics. Potential problems can be identified within the facility. The results of this study can be used to develop, test, and validate the system that has been used

The Corona Losses Detection Analysis at High Voltage

The increasing use and use of electricity in Indonesia causes the potential for greater losses in the transmission and distribution system. This causes many problems that arise, one of which is the corona in the transmission and distribution system. Corona mapping can only be detected through several ways, namely sound, light and distinctive smell. In this thesis, the aim is to detect the corona with the characteristics of a distinctive sense of smell, then the results of the detection are compared with the calculated corona losses. This distinctive odor is the smell of ozone which is produced from ionization at high voltage with the surrounding air, namely oxygen to form ozone molecules that are not permanent. The metal electrode to be tested is the copper tip metal. After testing the voltage of the appearance of the corona occurs at 7kV, high voltage when testing the tip of the copper metal point at a voltage of 21 kV is greater than the corona losses. The greater the voltage, the greater the corona losses generated

New Concept of PQR-Coordinate on Power Transformation for Harmonics Reducing

Power transformation of pqr-coordinate modified by Euler angle rotation method used in analysis of the IGBT active filter circuits as the instantaneous power theory is reviewed. Twice and three times rotation of Euler angle already conducted and produced a matrix transformation different from the Kim-Akagi’s model. Method of Fourier integral in the Voltage Source PWM Converter be done so a harmonics characteristic can be known and may be reduced. Value of Euler angles in frequency domain determined as a carrier harmonic waveforms. This approach is gives slightly different than that has understood so far

Opioid Use in Cancer Pain Management in Indonesia: a Call For Attention

Severe pain is a major problem for cancer patients, and pain management often requires the use of opioids. Indonesia is one of the countries where the use of opioids for cancer patients is extremely low, and this calls for attention, as many cancer patients in the country undergo unnecessary suffering as the consequence of this opioid underuse. The inability to assess pain correctly, failure to determine the correct dose, fear of addiction, overly tight regulation, all contribute to the failure to implement rational use of opioids for cancer patients. Breakthrough pain, a problem which requires special attention not only because it is commonly found but also requires proper knowledge to handle them. These hurdles are discussed in the present review, in order to bring a better understanding about the correct use of opioids in severe cancer pain. Some examples where opiods are used inappropriately in cancer pain management are also discussed.Key words: opioid, break through pain, cancer pain, morphine

Comparison of Voltage-Vector Control based on Duty Cycle Analysis in Three-Phase Four-Leg System Active Filter

Comparison of voltage vector control in various forms of tetrahedron that result from switching combination on three-phase four-leg system active filter is presented especially asymmetric tetrahedron shape which is a projection pqr-coordinate into αβ0-coordinate. Parameter tetrahedrons such as modulation boundary-line, reference vector, switching duration time and duty cycle are described. Duty cycle analysis conducted on the Shen’s model, the Zhang’s model, the Perales’s model and asymmetric’s model are presented. The characteristics results showed that switching combination of each IGBT conductor especially its reviews on the neutral wire. Asymmetric tetrahedron can be proposed as control technique in three-phase four-leg system active filter

Jaringan Mikro Arus Searah (Dc Microgrid) sebagai Upaya Ketersediaan Energi Listrik dalam Pengembangan Energi Terbarukan

Pengembangan sumber energi terbarukan merupakan pengembangan sumber energi yang potensial,seperti tenaga angin, matahari, dan sel bahan bakar hidrogen. Pembangkit listrik terdistribusimemberikan solusi atas penggunaan jaringan listrik mikro arus searah ( JLMAS), PengembanganJLMAS akan memberikan konstribusi dalam pengembangan distribusi pembangkitan dari beberapaenergi terbarukan dalam mengatasi ketersediaan energi listrik. JLMAS merupakan gabungan daribeberapa energi terbarukan yang menyuplai ke jaringan mikro, yang dapat bekerja bersamaandengan jaringan distribusi utama melalui konverter dua arah ( Biderectional Converter DC-AC)maupun bekerja sendiri dalam jaringan listrik mikro arus searah, makalah ini menjelaskan konsepJLMAS yang dapat diterapkan dalam sistim jaringan distribusi dari beberapa energi terbaruka

Implikasi Klinis Variasi Jumlah Copy Gen CYP2D6

Enzim CYP2D6 adalah salah satu varian sitokrom P450 (CYP450) yang berperan dalam metabolisme obat di hati. Isoform ini berperan dalam memetabolisme 25% obat yang saat ini beredar di pasaran. Aktivitas CYP450 dapat dipengaruhi oleh berbagai faktor seperti usia, jenis kelamin, fungsi organ pemetabolisme, jenis dan derajat penyakit, serta variasi genetik. Salah satu faktor penentu aktivitas CYP2D6 adalah sifat gene CYP2D6 yang sangat polimorfik. Faktor penentu polimorfisme gen CYP2D6 adalah mutasi pada nukleotida tunggal (single nucleotide polymorphisms (SNPs)) dan variasi jumlah copy (copy number variation (CNV)) gen CYP2D6. Kejadian mutasi gen dan variasi jumlah copy gen CYP2D6 dapat meningkatkan atau menurunkan aktivitas enzim CYP2D6 yang selanjutnya dapat menurunkan atau meningkatkan efikasi obat yang merupakan substrat CYP2D6 ataupun dapat menimbulkan toksisitas obat. Berbagai penelitian telah dilakukan untuk mengevaluasi hubungan mutase SNPs gen CYP2D6 dengan efek obat. Dalam tinjauan kali ini akan dibahas mengenai pengaruh variasi jumlah copy (copy number variation) gen CYP2D6 terhadap efek terapi ataupun efek samping obat

The Effect of High Switching Frequency on Inverter Against Measurements of kWh-Meter

In PV systems connected to the grid requires a kWh meter to measure the amount of power delivered to the grid, and an inverter to convert the DC voltage generated by PV into AC voltage. The latest generation of Inverter using the high switching frequency to obtain the inverter with good efficiency, small in sizes and lightweight. This led to the emergence of harmonics to the grid through the instrument of kWh meter, and caused the kWh-meter is not working properly. This study is intended to obtain the minimum value of the switching frequency which affect the results of measurement of Digital kWh meters. Kwh-meter tested by varying the switching frequency which is obtained from various types of inverters and from the simulator of switching of high frequencies

Novel Centralized Control Battery Operation, on Microgrids to Supply The Load Priority

Priority loads, in micro grid is preferred load to always get the power supply. Battery function, in micro grid, in addition, functioning as a storage energy, it also serves as a stabilizer of network, due to intermittent of energy sources, both solar and from wind. As energy storage, battery is intended to supply energy when other sources of energy is not available. So far, the mechanism of battery operation, distributed on each generation, so that when operation standalone, battery capacity is not in optimal level. In this study, proposed, method of centralized control battery operation, which would regulate the use of battery operation, especially to supply the load priority. So that the power supply from the battery to the load priority, it would be optimal in optimal level when other sources are no longer, by utilizing parameters weather and load forecast