Association between blood glucose levels at admission and severity of COVID-19 patients

Hyperglycemia can be experienced by corona virus disease (COVID-19) patients due to the invasion of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) into pancreatic cells or other mechanisms such as insulin resistance, counter-regulatory, stress induction, and glucocorticoid therapy. Hyperglycemia can stimulate the production of reactive oxygen species (ROS) and pro-inflammatory cytokines leading to an increase in the disease severity.  Based on the clinical and laboratory criteria, the severity of COVID-19 patients is classified into asymptomatic, mild, moderate, severe, and critical. This study aimed to investigate the association between blood glucose levels at admission and the severity of COVID-19 patients with and without diabetes mellitus (DM). It was a cross-sectional study using secondary data from COVID-19 patients in Pondok Kopi Jakarta Islamic Hospital from April to June 2021. This study involved 340 patients with comorbid DM (n=78) and without comorbid DM (n=262). The Mann-Whitney and Spearman correlation test were used. A significant difference between random blood glucose levels in comorbid DM patients and patients without comorbid DM (p<0.05). However, there is a weak correlation between random blood glucose levels and severity with comorbid DM (r=0.112) and without comorbid DM (r=0.129). In conclusion, a positive and weak correlation between blood glucose levels at admission and the severity of COVID-19. The severity increases as the blood sugar level increases. Further study needs to be performed considering other comorbid conditions

Antiviral Therapy for Hepatitis C Prophylaxis in Percutaneous Exposure and Acute Hepatitis C

Incidence of percutaneous exposure to hepatitis C virus (HCV) is still quite high, particularly in medical staffs. Though not all will cause infection, but if acute HCV infection occurs, it usually develops into chronic hepatitis which finally causes cirrhosis and hepatocellular carcinoma. Untill now, there is no standard method either in regiments, administration time, or duration of administration to prevent HCV infection after exposure occurs, as well as the use of antiviral therapy in acute HCV. HCV therapy target is viral eradication, thus the therapy response is defined using virological parameter than clinical parameter. Different from hepatitis B virus (HBV), immunoglobulin administration after exposure to HCV is not recommended as it is not proven to prevent transmission, similarly with pegylated interferon (PEG-IFN) or interferon (IFN) administration. In addition, several studies concluded that risk of HCV transmission after percutaneous exposure is low, therefore regular strict monitoring (monthly in the first 16 weeks after exposure) to clinical and laboratory results (HCV-RNA, alanine aminotransferase) is more required, so that detection and early treatment to acute HCV can be performed, considering that several studies showed that early monotherapy using IFN/PEG-IFN in acute HCV could reach quite high sustained virological response (SVR)

Pro-inflammatory cytokine (IL-6) and total count lymphocyte profiles in COVID-19 patients with different severity levels

COVID-19 is caused by the SARS-CoV-2 infection that attacked the human respiratory system. In severe conditions, it causes pneumonia, kidney failure, acute respiratory distress syndrome (ARDS), and even death. The SARS-CoV-2 infection triggers the immune cells to secrete an excess of pro-inflammatory cytokines lead to cytokine storm. It is believed to become one of the mechanisms that cause the ARDS condition. The level of pro-inflammatory cytokines will differ with each case severity. This study aimed to evaluate the profile of pro-inflammatory cytokines in COVID-19 patients with different severity. Therefore, it could be used as therapeutic approach for cytokine storm conditions. It was a cross sectional study using plasma samples of COVID-19 patients from Jakarta Islamic Hospital, Pondok Kopi and Dr. M. Goenawan Partowidigdo Hospital, Cisarua, Indonesia. The COVID-19 patients with severe (n=20) and mild to moderate (n=25) severity were involved in this study. As negative control plasma sample from healthy subjects (n=13) was used. Plasma IL-6 levels were measured using the ELISA technique and plasma lymphocyte levels were measured using a hematology analyzer. The results showed that no significant difference between severity and gender was observed (p=0.256). Meanwhile, there is a significant difference in IL-6 level between negative control, mild-moderate, and severe categories (p=0.015). The average IL-6 level in severe categories was higher than mild-moderate and negative control categories, with values 105.375, 59.75, and 64.577 pg/mL, respectively. This result becomes supporting evidence that there is a cytokine storm condition in severe COVID-19 patients. Furthermore, the lymphocyte level in the severe group is significantly lower than the mild to moderate group. This result may indicate lymphocytopenia in the severe group

Pengaruh Hiperglikemia Admisi terhadap Major Adverse Cardiac Events Selama Perawatan pada Pasien Sindrom Koroner Akut di ICCU RSCM, Jakarta

Penelitian ini bertujuan untuk mengkaji peran hiperglikemia admisi sebagai prediktor Major Adverse Cardiac&nbsp;Events (MACE) dan mengetahui pengaruhnya terhadap kecepatan terjadinya MACE pada Sindrom Koroner Akut(SKA). Studi kohort retrospektif dengan pendekatan analisis kesintasan dilakukan terhadap 442 pasien SKA yangdirawat di ICCU RSCM tahun 2008-2012. Pasien dibagi tiga kelompok berdasarkan konsentrasi glukosa darah(GD) admisi (GD &le;140mg/dl, 141-200mg/dL, dan &gt;200mg/dL). Sebanyak 63 (14,25%) pasien mengalami MACEdengan rerata waktu kesintasan 6,3 hari dan (IK 95% 6,22-6,52 hari). MACE tercepat pada GD admisi &gt;200 mg/dL, 141-200 mg/dL, dan &le;140 mg/dL dengan rata-rata kejadian masing-masing pada hari perawatan ke-5,9; 6,0;dan 6,6 (log rank &lt;0.001). Hiperglikemia admisi merupakan prediktor independen MACE selama perawatan (adjustedHR 2,42; IK 95% 1,04-5,58 untuk GD admisi 141-200 mg/dL dan adjusted HR 3,59; IK 95% 1,03-12,46untuk GD admisi &gt;200 mg/dL). Terdapat perbedaan kesintasan pada kelompok hiperglikemia admisi dalam terjadinya MACE. Semakin tinggi konsentrasi glukosa darah pasien SKA saat admisi semakin tinggi risiko dan semakin cepat pula terjadi MACE selama perawatan.Kata kunci: Hiperglikemia admisi, MACE, kesintasa

PENGARUH POSTER EDUKASI TERHADAP DUKUNGAN KELUARGA DAN PERILAKU MANAJEMEN DIRI PASIEN DIABETES MELLITUS TIPE 2 ANGGOTA PERSATUAN DIABETES INDONESIA (PERSADIA) RUMAH SAKIT JOGJA

BACKGROUND: Every six seconds one person in the world died because of diabetes. To prevent this problem, the exact self-management behaviors of patients with type 2 diabetes mellitus are needed. In the application of selfmanagement behaviors, there are a direct effect of family support and education. However, the level of family support and self-management behavior in Persadia RS Jogja still low. Then the education process is required, one of which is the educational poster. OBJECTIVE: This study aimed to determine the effect of educational poster to family support and self-management behavior of patients with type 2 diabetes mellitus member of Persadia RS Jogja. METHOD: The study was a pre-experimental one group pretest and posttest design with no control. Subjects were patients with type 2 diabetes mellitus member of Persadia RS Jogja the number of research subjects is 34 people who received treatment in the form of educational poster one time at the beginning of the study and a brief educational messages once every three days. Assessments of family support and self-management behavior performed at the beginning and the end of the study with a span of three weeks. RESULT: Based on t-test there are significant educational posters to the family support (� t � = 2.79) and self-management behavior (� t � = 2.09). The relationship between family support and self-management behavior increased after the educational posters were given (r = 0.814). CONCLUSION: There is an educational poster effect to the increase of family support and self-management behavior of patients with diabetes mellitus type 2 member of Persadia RS Jogja. Educational poster also reinforces the relationship between family support and self-management behaviors