IntroductionThe COVID-19 pandemic has caused disruptions in educational institutions across the country, prompting medical schools to adopt online learning systems. This study aims to determine impact on medical education and the medical student’s attitude, practice, mental health after 1 year of the Covid-19 pandemic in Indonesia.MethodsThis study utilized a cross-sectional design. An online questionnaire was distributed digitally to 49 medical schools in Indonesia from February–May 2021. A total of 7,949 medical students participated in this study. Sampling was carried out based on a purposive technique whose inclusion criteria were active college students. This research used questionnaires distributed in online version among 49 medical faculties that belong to The Association of Indonesian Private Medical Faculty. Instruments included demographic database, medical education status, experience with medical tele-education, ownership types of electronic devices, availability of technologies, programs of education methods, career plans, attitudes toward pandemic, and the mental health of respondents. Univariate and bivariate statistical analysis was conducted to determine the association of variables. All statistical analyses using (IBM) SPSS version 22.0.ResultsMost of the respondents were female (69.4%), the mean age was 20.9 ± 2.1 years. More than half of the respondents (58.7%) reported that they have adequate skills in using digital devices. Most of them (74%) agreed that e-learning can be implemented in Indonesia. The infrastructure aspects that require attention are Internet access and the type of supporting devices. The pandemic also has an impact on the sustainability of the education program. It was found that 28.1% were experiencing financial problems, 2.1% postponed their education due to this problems. The delay of the education process was 32.6% and 47.5% delays in the clinical education phase. Around 4% student being sick, self-isolation and taking care sick family. the pandemic was found to affect students’ interests and future career plans (34%). The majority of students (52.2%) are concerned that the pandemic will limit their opportunities to become specialists. Nearly 40% of respondents expressed anxiety symptoms about a variety of issues for several days. About a third of respondents feel sad, depressed, and hopeless for a few days.ConclusionThe infrastructure and competency of its users are required for E-learning to be successful. The majority of medical students believe that e-learning can be adopted in Indonesia and that their capacity to use electronic devices is good. However, access to the internet remains a problem. On the other side, the pandemic has disrupted the education process and mental health, with fears of being infected with SARS-CoV-2, the loss of opportunities to apply for specialty training, and the potential for increased financial difficulties among medical students. Our findings can be used to assess the current educational process in medical schools and maximize e-learning as an alternative means of preparing doctors for the future.
Sysmex XN-1000 hematology analyzer is an automated 5-part diff analyzer (eosinophils, basophils, neutrophils, lymphocytes, and monocytes). In the calculated area, the type of difference between the Sysmex hematology device and other hematology devices is Immature Granulocyte (IG), Nucleated Red Blood Cell (NRBC), and High Fluorescent Lymphocytes Count (HFLC). The cells calculated in the HFLC area are atypical lymphocytes. In patients with dengue hemorrhagic fever, it is often found atypical lymphocytes called blue plasma lymphocytes. The purpose of this study was to determine the description of HFLC in patients with dengue fever using the hematology analyzer Sysmex XN-1000. A descriptive retrospective study was conducted during April-May 2017. The subjects of the study were adult patients diagnosed with dengue hemorrhagic fever with WHO criteria. Of the 47 samples of Dengue Hemorrhagic Fever (DHF) patients, the average HFLC results were between 2.0-32.3%, which was 11.5%, while the average range of normal HFLC values was between 0.0-1.4% and was 0.3%. In cases of DHF, there is an increase in HFLC. This is likely to be attributed to atypical lymphocyte increase in dengue hemorrhagic fever. Further research with more varied samples still needs to be done.
Plasma cell leukemia (PCL) is the most aggressive form of the plasma cell dyscrasias. This rare disease remains a challenge in regard to diagnosis and treatment due to its rarity and aggressive nature. PCL is a rare plasma cell malignancy with poor prognosis. There is still limited literature and numerous trials on this disease treatment. Novel agents and autologous stem cell transplant can be given to prolong survival and increase life quality. Reports on PCL is very important for references regarding future treatments.
Kanker pankreas adalah keganasan sel di jaringan pankreas. kejadiannya meningkat pada usia di atas 60 tahun. Namun, sekitar20% dapat terjadi di usia muda. Patogenesis terjadinya masih belum jelas, dikemukakan bahwa mutasi genetik dan faktor eksogen sepertimerokok berhubungan dengan terjadinya keganasan sel pankreas. Kasus adalah seorang laki-laki perokok berusia 31 tahun dengankeluhan utama nyeri ulu hati menjalar ke punggung, disertai mual, muntah, nafsu makan turun. Pada pemeriksaan fisik didapatkansklera ikterik, perkusi redup dan ronkhi di paru, distensi abdomen dan asites. Pada pemeriksaan laboratorik didapatkan leukositosis,trombositopenia, peningkatan aspartate aminotransaminase (AST) lebih dari 10 kali Upper Range Limit (URL), hiperbilirubinemiadirek, peningkatan alkaline phosphatase (ALP), Gamma Glutamyl Transferase (GGT) dan lipase serum, sedangkan amilase serumnormal. Terdapat juga peningkatan kadar CA19-9. Pada computed tomography scan (CT scan) dan Magnetic Resonance Imaging (MRI)didapatkan gambaran kanker pankreas primer yang telah bermetastasis ke pleura dan hati. Kadar amilase normal di pasien dapatdisebabkan karena awal peningkatan dan penurunan kadar amilase terjadi lebih cepat dan pada saat diperiksa telah turun mencapaikadar normal. Simpulan, kanker pankreas dapat terjadi di usia muda. Amilase yang normal dapat terjadi di kanker pankreas.
<p><strong>Latar Belakang</strong>: <em>Pseudothrombocytopenia </em>adalah fenomena dimana jumlah trombosit yang dilaporkan oleh alat hitung otomatis jumlahnya lebih sedikit dibandingkan jumlah sesungguhnya pada sirkulasi invivo</p><p><strong>Kasus</strong>: Seorang laki-laki 53 tahun kontrol rutin untuk penyakit diabetes melitus. Pada pemeriksaan fisik dalam batas normal. Pada pemeriksaan darah lengkap pertama dengan menggunakan antikoagulan <em>Ethylene Diamine Tetraacetic Acid</em> (EDTA) didapatkan hemoglobin 15,7 gr/dL, MCV 82,3 µm3, MCH 30,3 pg, MCHC 36,8 %, Eritrosit:5,19 jt/L, RDW 11,8 %, Hematokrit 42,7 %, leukosit 7.270/cmm, trombositopenia dengan jumlah trombosit 15.000/cmm dan <em>immature platelet fraction </em>(IPF) 49,8 %. Pada pemeriksaan darah lengkap kedua dengan menggunakan antikoagulan natrium citrat didapatkan hemoglobin 15,2 gr/dL, MCV 81,4 µm3, MCH 30,1 pg, MCHC 37,0 %, Eritrosit:5,05 jt/L, RDW 11,4 %, Hematokrit 41,1 %, leukosit 9.690/cmm, thrombosit menjadi 222.000/cmm dan IPF sebesar 5.1%. Pada hapusan darah tepi sampel pertama ditemukan trombosit yang bergerombol (<em>clumping</em>).</p><p><strong>Diskusi</strong>: .<em>EDTA-dependent pseudothrombocytopenia</em> (EDP) merupakan fenomena <em>invitro </em>yang disebabkan oleh protein spesifik dari sampel yang hanya bereaksi dengan trombosit apabila terdapat EDTA dan menyebabkan <em>clumping</em>. Pada perubahan pemeriksaan IPF yang tinggi dengan menjadi normal dapat disebabkan oleh EDP.</p><p><strong>Simpulan</strong>: Apabila ditemukan pemeriksaan IPF yang tinggi dengan trombositopenia maka sebaiknya dilakukan pemeriksaan hapusan darah tepi untuk melihat ada tidaknya thrombosit yang bergerombol</p><p><strong> </strong></p><p><strong>Kata Kunci: </strong><em>EDTA-dependent pseudothrombocytopenia</em> (EDP), trombositopenia, IPF<strong></strong></p>
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