Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Knowing the severity of COVID-19 is important during a pandemic. Measurement of Lactate Dehydrogenase (LDH) levels is a simple, quick, and widely available laboratory test in most health facilities. Lactate dehydrogenase levels change significantly in patients with tissue damage including COVID-19 disease. The purpose of this study was to analyze the LDH levels as a marker of the severity of COVID-19. The research method used was a cross-sectional approach using primary data from 70 suspected COVID-19 patients from June to July 2021 at Labuang Baji Hospital, Hasanuddin University Hospital, and Makassar City Hospital. Samples were grouped into mild, moderate, and severe COVID-19. The LDH levels at the time of hospital admission were measured using an Architect device. Chi-Square, Kruskal-Wallis, and ROC curve statistical tests were used to obtain the LDH value with a significant value of p<0.05. The sample consisted of 24 mild COVID-19, 23 moderate COVID-19, and 23 severe COVID-19. The LDH levels in mild COVID-19 were 101.00 U/L (74.00-156.00 U/L) significantly different from moderate COVID-19 was 143.00 U/L (126.00-253.00 U/L) and COVID-19 were 291.00 U/L (177.00-655.00 U/L) (p<0.001) and had a very strong positive correlation (r=0.914). The ROC curve showed that LDH had a sensitivity of 91.3%, specificity of 94.7% with the cut-off >250.5 U/L, NPV of 96.4%, PPV of 87.5%, and accuracy of 91.3%. LDH levels increase along with the increasing severity of COVID-19 caused by tissue damage due to increased inflammatory response. LDH can be used as a marker of COVID-19 severity.
The Neutrophil-Lymphocyte Ratio (NLR) and procalcitonin are used to indicate systemic inflammation in variousmedical disorders. Both parameters were determined in this study to predict the severity of acute pancreatitis. This studywas a cross-sectional study using a retrospective approach to patients diagnosed with acute pancreatitis by using medicalrecord data from patients at Dr. Wahidin Sudirohusoso Hospital, Makassar, from January 2014 to May 2019. This studycomprised 35 patients hospitalized with acute pancreatitis, with a similar proportion of males and females. This studydiscovered that the mean age in this study was 44.17±12.9 years. The most prevalent cause was Gallstones (77.1%), themost severe degree was mild (54.2%), and the highest outcome was survival (77.1%). The NLR (9.93±11.19, p=0.011)increased in proportion to severity. However, additional analysis based on classification of disease severity revealed thatonly mild-severe NLR was significant (p=0.005). Procalcitonin (8.13±11.25, p=0.001) increased along with the increaseddisease severity, and the subsequent analysis showed that the distribution of severity was similar. The NLR can predict theseverity of acute pancreatitis but is less effective than procalcitonin. This study required a more proportional subjectpopulation and consideration of other factors.
EVALUATION OF PLEURA EFUSION DETERMINATION BY LIGHT’S DAN HEFFNER’S CRITERIANordjannah1, Ani Kartini2, Darmawaty ER 31 Medical Doctor Specialist Education Programe of Clinical Pathology, Faculty of Medicine Hasanuddin University/dr.Wahidin Sudirohusodo Hospital, Makassar2 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Labuang Baji Hospital Makassar3 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Hospital Islam Faisal Hospital Makassar ABSTRACT Background : Pleural effusion is a condition of abnormal pleural fluid accumulation in the pleural cavity due to excessive transudation or exudation. Light’s criteria is used as the standard method to distinguish between exudates and transudates. Some recent studies reported misclassifications so several alternative criteria are developed, one of which is Heffner’s criteria. The purpose of this study was to determine the sensitivity and specificity of Heffner’s criteria in determining the type of pleural effusion.Methods : An observational study with cross sectional method using a pleural effusion fluid sample of patients examined at the Clinical Pathology Laboratory Instalation at Wahidin Sudirohusodo Hospital on July 2018. Total protein, LDH and cholesterol levels were examined in all samples that met the inclusion and exclusion criteria.Results : There were 45 samples of pleural effusion, 30 of which classified as transudate and 15 samples as exudates. Based on clinical diagnosis, the Light’s criteria obtained 3 misclassifications and Heffner’s criteria obtained 2 misclassifications. Based on the data above, the statistical data showed that Light’s criteria has sensitivity of 96,7 % and specificity of 86,7 %. Heffner’s criteria has sensitivity of 100 % and specificity of 86,7 %. Conclusion : Heffner’s criteria offers better sensitivity and specificity than Light’s criteria. Heffner’s criteria can be used as an alternative in determining the type of pleural effusion Keywords: Heffner’s criteria, Light’s criteria, transudate, exudate, pleural effusion
Dengue Haemorrhagic Fever (DHF) may result acute liver failure. Although these cases are rare but is more common in children, and early identification of these infections is important to reduce the morbidity as well as mortality. The aim of this study was to know the determinations and the correlation of liver functions with the grade of Dengue Haemorrhagic Fever in children. This study was conducted by cross sectional, using data from the medical records of DHF patients who had liver function tests (AST, ALT, PT, aPTT and albumin) in the Laboratory of Clinical Pathology Dr. Wahidin Sudirohusodo Hospital Makassar from the period of July 2008 to June 2010. AST, ALT and albumin were tested using Cobas Integra 400, PT and aPTT were tested using Humaclot VA, and the data were analyzed with Spearman correlation test. There were fifty-five samples: 26 (47.3%) were males and 29 (52.7%) were females. We found 15 (27.3%) grade I, 13 (23.6%) grade II, 16 (29.1%) grade III and 11 (20%) grade IV patients. In this study are found that AST and ALT increased and there is a tendency of extending aPTT value but there was no significant correlation with the grade of DHF. The mean of albumin was lower in grade IV, there was a significant correlation between albumin and the grade of DHF (r=–0.375, p<0.05). In conclusion, there was a significant correlation between albumin and the grade of DHF. It is suggested that the routine albumin examination in DHF patients should be carried on to know whether a prevention of complications is needed to reduce the possibility of mortality.
Coagulation activation and thrombosis frequently exist in ischemic stroke, thrombus formation can be detected early by the presence of fibrin monomer. The purpose of this study was to know the correlation of fibrin monomer level with cerebral infarct size in acute ischemic stroke patients. This was a cross sectional study with a total of 39 samples. The fibrin monomer level was determined by immunoturbidimetry method using STA-Compact and the measurement of the infarct size was done by CT scan of the head using Broderick formula. The results of this study showed that the median level of fibrin monomer in acute ischemic stroke with nonlacunar infarct type and lacunar infarct type were 14.46 μg/mL and 4.29 μg/mL, respectively. Mann-Whitney test showed there was a significant difference of fibrin monomer levels between nonlacunar infarct type and the lacunar type, p=0.000. The cut-off point analysis result of the fibrin monomer level was 5.96 μg/mL with a sensitivity of 88.9% and specificity of 76.4%, respectively. Spearman correlation test showed that fibrin monomer level was positively correlated with cerebral infarct volume in acute ischemic stroke (r=0.56, p=0.000). Based on this study, it can be concluded that fibrin monomer level can be used as a marker to predict the type of cerebral infarct and volume of acute ischemic stroke as well.
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