Prevalence ratio of free fatty acid in obese group with non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is liver disorders characterized by macrovesicular fatty liver, fibrosis, cirrhosis that not associated with alcohol consumption. The prevalence of NAFLD has risen with a pandemic of obesity. The increase of free fatty acid (FFA) oxidation will induce endoplasmic reticulum stress that cause mitochondrial dysfunction and lead to increase reactive oxygen species (ROS) production causing apoptosis of liver cells. The aim of  study was to determine the prevalence of FFA in the obese group. This was an observational analytical study with cross-sectional design to determine the prevalence ratio of FFA in the obese group with NAFLD compared to the group without NAFLD. Obese women who fulfill the inclusion and exclusion criteria were involved in this study. Five mL venous blood sample was collected for the measurement of lipid profile, liver enzyme and FFA. Fatty liver was evaluated using abdominal USG. The Chi-square test was used to analyze different proportions of FFA between the both groups. Sixty four subjects were participated in this study and classified into obese with NAFLD (39 subjects) and obese without NAFLD (25 subjects). The prevalence ratio of FFA with cutoff value ≥2.66 nmol/mL in the obese group with NAFLD was 4.3 times higher than those without NAFLD (95% IC: 3.5 – 42.3; p<0.001)

A male Covid-19 convalescent plasma donor with long existence of SARS-Cov-2 antibodies: a case report

Covid-19 Convalescent Plasma (CCP) was one of alternative therapy for Covid-19 patients. The use of convalescent plasma as an adjunct therapy must consider its efficacy, benefits, and risk, both for the patient and the donor. Convalescent Plasma was produced from purified human plasma. Convalescent Plasma was a passive immunity which provide active antibodies. CCP give immunity to the patient through the transfusion of a survivor’s antibodies. We were reporting a case of male CCP donor with long existence of SARS-Cov-2. This donor performed up to 16 donations, which was an unusual case in CCP donor. The SARS-CoV-2 antibody titer was analyzed using Elecsys® Anti-SARS-CoV-2 (Roche Diagnostics). The SARS-CoV-2 antibody showed high level of total SARS-CoV-2 antibodies, with the Cut off Indexes (COI) anti SARS-Cov-2 antibody were still quite high (132 U/mL). The highest donor antibody COI (204.6 U/mL) was seen in 11th donation at 6 months after recovery, while the lowest antibody COI (130.8 U/mL) was in 15th donation at 7 months after recovering. Evaluation of donor health status were performed after the 16th donation and analyzed as well. In conclusion, 16 CCP donations of 600 mL resulting in 48 units of 200 mL plasma in 8 months was safe for the donor, with the SARS-Cov-2 antibody titer remained high in the whole period

The risk of elevated plasma fibrinogen level in hypertensive and normotensive patientsafter bevacizumabintravitreal injection in diabetic retinopathy

Bevacizumab intravitreal injection (IVB) could be detected in plasma that might cause an imbalance in the coagulation system. A hypercoagulable state is potentially involved in the risk for thrombosis, which is associated with high cardiovascular mortality.The objective of the current study was to investigate the risk of elevated plasma fibrinogen levelsin hypertensive and normotensive patients after IVB in diabetic retinopathy. This study was conducted at Dr. Sardjito General Hospital, Yogyakarta from March to June 2019. A total of 64 patients were enrolled in the study, included of 32 hypertensive and 32 non-hypertensive patients with diabetic retinopathy who underwent IVB. Patients were interviewed and investigated for physical condition and opthalmological examination. Fibrinogen levelwas measured before and 1 week after IVB. The mean fibrinogen level beforeand after IVB was slightly high in hypertensive patients than normotensive but not significantly different(p>0.05). There was no significant risk of increased fibrinogen levels after IVB in the hypertension group compared to the normotension group in diabetic retinopathy patients. The proportion of patients at high risk for cardiovascular disease after IVB was not significantly different between both groups

Distribution of antimicrobial resistance genes of methicillin-resistant Staphylococcus aureus isolated from animals and humans in Yogyakarta Indonesia

Background and Aim: Methicillin-resistant Staphylococcus aureus (MRSA) has been known as a highly pathogenic bacteria in animals and humans, which is still becoming a global health issue. The prevalence of MRSA infection continues to increase worldwide and has become a global concern as a dangerous zoonotic disease. The World Health Organization estimates that by 2050 MRSA will be the leading cause of death. This study aimed to estimate the prevalence of MRSA in S. aureus isolates of veterinary and human origin in Yogyakarta, Indonesia. Materials and Methods: A total of 42 cases of S. aureus infection were examined in this study, consisting of nine isolates from cattle, five from goat, and 28 from human. All isolates were confirmed as S. aureus based on bacterial culture and detection of 23S rRNA and thermonuclease nuc gene by polymerase chain reaction (PCR). Results: Among 42 isolates, 35 isolates (83.3%) were identified as MRSA by PCR positive of mecA gene encoding methicillin resistance. Most MRSA strains were found in human isolates (100%), followed by cattle isolates (55.5%) and goats (40%). All MRSA strains were also multi-resistant to penicillin (blaZ gene) and tetracycline (tetK, and tetM genes) with a prevalence of about 98%. Conclusion: MRSA prevalence in humans and animals has increased significantly in Yogyakarta, Indonesia, compared to the previous study. The antimicrobial resistance pattern of MRSA animal isolates tends to be similar to humans and, thus, raises public health concerns about MRSA zoonotic spread

Profil Pemeriksaan Fragilitas Osmotik Eritrosit di RS. Dr. Sardjito

Osmotic fragility test (OFT) is performed to differentiate anemia diagnose with erythrocyte physical changing. In thalassemia and hemolytic anemia, OFT probably gave variation results that can cause erroneous anemia etiology trac¬ing. Aims of this research are to describe the OFT profile and its comparison with peripheral blood morphology in thalassemia and hemolytic anemia.The method, this retrospective study was conducted in Dr. Sardjito hospital at January 2002 to June 2004. Chi-Square test was used to compare thalassemia and hemolytic anemia proportion in the OFT groups. OFT results from 61 sub¬jects were : increasing 17 (27,8%), increasing-decreasing 17 (27,8%), de¬creasing 15 (24,4%), and normal 12 (20%). There were significantly differ-ence proportions in thalassemia group between decreasing OFT to increasing and normal OFT (p-0,005 ; p=0,002), but no difference to increasing-de¬creasing group. In hemolytic anemia group, the difference proportion found significantly between increasing OFT to normal, increasing-decreasing and decreasing OFT (p=0,03; p-0,005; p=0,000, respectively). In increasing-de¬creasing OFT group, there was no difference in type anemia (p=0,32). Mor¬phologically, target cell was found in 81 % of thalassemia, and spherocyte in 70% of hemolytic anemia. In Dr. Sardjito Hospital, OFT gave variation profile and in Thalassemia and hemolytic anemia groups, morphology evaluation are needed to confirm OFT results.Latar Belakang: Pemeriksaan fragilitas osmotik eritrosit (FOE) ini dilaksanakan untuk membantu diagnosis banding beberapa jenis anemia dengan sifat fisik eritrosit berubah. Aplikasi klinis, Talasemia dan anemia hemolitik memberikan hasil bervariasi sehingga dapat menimbulkan kesalahan interpretasi dalam melacak jenis maupun etiologi anemia.Tujuan penelitian ini adalah mengetahui variasi hasil FOE dan kesesuaian gambaran morfologi darah tepi pada talasemia dan anemia hemolitik. Penelitian retrospektif ini dilakukan menggunakan data rekam medik. Subyek adalah pasien yang diperiksa fragilitas osmotik eritrositnya di laboratorium Patologi Klinik RS. Dr. Sardjito antara Januari tahun 2002 sampai dengan Juni 2004. Uji Chi- square terhadap proporsi talasemia dan anemia hemolitik pada kelompok hasil FOE. Dari 61 subyek, variasi hasil FOE meliputi : peningkatan fragilitas 17 (27,8%), penurunan fragilitas 17 (24,4%), campuran peningkatan dan penurunan 15 (27,8%) dan normal 12 (20%). Terdapat perbedaan bermakna proporsi talasemia kelompok penurunun FOE terhadap kelompok peningkatan FOE (p=0,005) dan FOE normal (p= 0,002), namun tidak berbeda bermakna dengan hasil campuran penurunan dan peningkatan fragilitas (p= 0,26). Terdapat perbedaan bermakna proporsi ane¬mia hemolitik pada kelompok dengan peningkatan FOE terhadap kelompok normal FOE, campuran penurunan dan peningkatan FOE dan penurunan FOE (p =0,03; p= 0,005; p= 0,000). Tidak terdapat perbedaan bermakna proporsi jenis anemia pada hasil campuran penurunan dan peningkatan FOE (p= 0,32). Gambaran morfologi darah tepi pada kelompok talasemia, 81% memiliki sel target dan pada kelompok anemia hemolitik, 70% memiliki sel spherosit.Hasil FOE di RS Dr. Sardjito menunjukkan gambaran variasi, talasemia maupun anemia hemolitik membutuhkan konfirmasi morfologi darah tepi untuk meninjau kesesuaiannya

The effect of excessive disodium ethylene diamine tetraacetic acid (Na₂EDTA) anticoagulant concentration on leukocytes profile in peripheral blood examination

<p>Accuracy of leukocytes profile assessment is influenced by several pre analytical factors, among others, the anticoagulant concentration. EDTA is one of the most frequently used anticoagulant in peripheral blood examination. Several references stated that inappropriate concentration of EDTA anticoagulant in blood sample may affect the result of leukocytes profile in peripheral blood examination. The aim of this study was to evaluate whether there are differences among leukocytes profile in peripheral blood examination specimens, which were prepared with excessive Na₂EDTA anticoagulant in different concentration. This study was conducted in Faculty of Medicine, Gadjah Mada University. Blood samples from 30 subjects were taken using vein puncture. Two millimeters blood was divided into 4 Na₂EDTA-containing tubes. Before that, one drop of blood without Na₂EDTA anticoagulant was used to make blood film right after vein puncture, as control. Each tubes contained different concentration of anticoagulant. The first tube contained Na₂EDTA in standard concentration 2 mg/ml; the remaining tubes contained 4 mg/ml, 6 mg/ml, and 8 mg/ml respectively. These samples were immediately examined using SYSMEX SE-9500 automatic cell counter to measure the total and differential leukocytes count; and were stained with Wright staining for morphological examination under the microscope. These procedures were done before 20 minutes of vein puncture. There were significant decrement of total leukocytes count, absolute differential leukocytes count and monocyte percentage following excessive Na₂EDTA administration. Neutrophil percentage was found to be relatively increased and the difference was significant. Lymphocyte, eosinophil and basophil percentages were not significantly different. Morphological examination showed significant increment in irregular cytoplasm margin, vacoulation and irregular nuclei lobes following excessive Na₂EDTA administration. It is concluded that excessive concentration of Na₂EDTA used in blood specimen preparation, will lead to changes in leukocytes profile as the concentration increased. Standard Na₂EDTA anticoagulant concentration did not alter any leukocytes count and morphology, except for irregular cytoplasm margin and irregular nuclei lobes. <em><strong>(Med J Indones 2007; 16:168-75)</strong></em></p><p><strong>Keywords:</strong> <em>Na2EDTA, anticoagulant, leukocytes profile, leukocytes count, leukocytes morphology</em></p

Negative Correlation between cross-linked fibrin degradation products (d-dimer) and glasgow coma scale (GCS) scores in patients with head injury

Traumatic Brain Injury (TBI) is damage in the brain caused by a traumatically injuring external force. To observe its severity, the Glasgow Coma Scale (GCS) and Computed Tomography (CT) scan are used. In addition, D-dimer as an end product of fibrinolytic activity is proposed as the predictor of TBI outcome. The increase of D-dimer value is correlated with severity. CT-scan is too expensive and requires patients’ mobility that can cause worse incidents. The aim of this study was to correlate between D-dimer and GCS in patients with traumatic brain injury. The cross sectional observational analytic design was carried out in the study. The TBI patients with 24 hours onset admitted to Emergency Room Dr. Sardjito Hospital Yogyakarta will be included with inclusion and exclusion criteria consecutively. Glasgow coma scale was measured and plasma D-Dimer was examined using Nycocard with immunofiltration method. Correlation between plasma D-Dimer and Glasgow Coma Scale was tested using Pearson Correlation when the population distribution was normal and Spearman when it was not normally distributed. There was a strong negative correlation between D-dimer and Glasgow Coma Scale (r=-0.622; p<0.001) and Prothrombin Time with D-dimer value (r=0527; p<0.001). Moreover, it was found that haemoglobin had a correlation with D-dimer (r=-0.517; p=0.001). Haemoglobin and PT had a correlation with Glasgow Coma Scale (r=0.419 vs -0.591; p<0.001) and neutrophil had poor correlation with Glasgow Coma Scale (r=-0.336; p=0.034). In conclusion, there was a strong negative correlation between degradation product of cross-linked fibrin (D-dimer) and Glasgow Coma Scale in patients with traumatic brain injury. Keywords: D-Dimer - Glasgow Coma Scale - Traumatic Brain Injury - CT scan - correlatio