Summary Ivermectin is an FDA‐approved drug for a parasitic disease that has broad antiviral activity. This study aims to analyse the efficacy of ivermectin in improving the Covid‐19 outcomes. We systematically searched the PubMed, Europe PMC and ClinicalTrials.gov database using specific keywords related to our aims until 10th May 2021. All published randomized clinical trial studies on Covid‐19 and ivermectin were retrieved. The quality of the study was assessed using Jadad scale assessment tool for clinical trial studies. Statistical analysis was done using Review Manager 5.4 software. A total of 19 studies with 2768 Covid‐19 patients were included in this meta‐analysis. This meta‐analysis showed that ivermectin was associated with reduction in severity of Covid‐19 (RR 0.43 [95% CI 0.23–0.81], p = 0.008), reduction of mortality (RR 0.31 [95% CI 0.15–0.62], p = 0.001), higher negative RT‐PCR test results rate (RR 1.23 [95% CI 1.01–1.51], p = 0.04), shorter time to negative RT‐PCR test results (mean difference [MD] −3.29 [95% CI −5.69, −0.89], p = 0.007), higher symptoms alleviations rate (RR 1.23 [95% CI 1.03−1.46], p = 0.02), shorter time to symptoms alleviations (MD −0.68 [95% CI −1.07, −0.29], p = 0.0007) and shorter time to hospital discharge (MD −2.66 [95% CI −4.49, −0.82], p = 0.004). Our study suggests that ivermectin may offer beneficial effects towards Covid‐19 outcomes. More randomized clinical trial studies are still needed to confirm the results of our study.

Figure 2 Urticaria involving face, on the right side (a) and left side of the face (b).

Coronavirus Disease 2019 (COVID‐19) is a public health emergency of international concern with increasing cases globally, including in Indonesia. COVID‐19 clinical manifestations ranging from asymptomatic, acute respiratory illness, respiratory failure that necessitate mechanical ventilation and support in an intensive care unit (ICU), to multiple organ dysfunction syndromes. Some patients might present with happy hypoxia, a condition where patients have low oxygen saturations (S pO2 < 90%), but are not in significant respiratory distress and often appear clinically well, which is confusing for the doctors and treatment strategies. Most infections are mild in nature and have a relatively low case fatality rate (CFR); however, critical COVID‐19 patients who need support in ICU have high CFR. We would like to report a case of happy hypoxia in a critical COVID‐19‐positive ICU hospitalized patient who survived from Indonesia.

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We have read with great interest the articles regarding cutaneous manifestations in Coronavirus Disease 2019 (COVID-19) infection. Studies showed 20.4% of COVID-19 patients developed cutaneous manifestations. COVID-19 causes vascular endothelial injury, vasculitis and prothrombotic state which might be the underlying cause of hemorrhagic cutaneous manifestations, disseminated intravascular coagulation (DIC), and multiple organ failures. To date, hemorrhagic cutaneous manifestations reported are chilblain-like lesion, purpura to ecchymosis, livedo reticularis, and dry gangrene. We present a case of ecchymosis in COVID-19-positive ICU hospitalized patient.

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Long-held assumptions of poor prognoses for patients with HM have meant that clinicians have been reluctant to admit them to the intensive care unit (ICU). However, over the past few years several centers across the world have shown that it is possible to achieve a meaningful survival in these patients. Methods: The aim of this study was to assess the characteristics and outcomes of patient with haematological malignancy admitted to the intensive care unit (ICU). We performed a retrospective cohort study among adult HM patients admitted to the ICU in Moewardi Hospital between January 2015 and December 2016. Medical history, physical and laboratory findings on admission, and therapeutic interventions during ICU stay were recorded. The study endpoint was ICU mortality. Results: Nineteen patients were admitted to ICU, the median age was 52 years (21-73), and 67% were female. The mean ICU length of stay was 3 days (SD 2.8). The main acute life-threatening diseases precipitating ICU transfer were septic shock (8 patients, 44%) and respiratory failure (5 patients, 28%). Acute Myeloid Leukemia (AML) was the main diagnosis in this study (39%). Most of these patients had anemia (72%) with the median of hemoglobin was 8.8 (3.9-12). Twenty eight percent of patients needed invasive mechanical ventilation and 60% of these died. ICU mortality was 50%. Conclusions: Patients admitted to ICU with HM have high mortality. Early recognition of critical illness is required to enable prompt referral of patients who may benefit from critical care. Multicenter outcome studies on patients with HM who require ICU admission are needed.

Suppliers are one of the important things in purchasing activities of various needs for the company. Supplier selection is a multi-criteria problem that includes quantitative and qualitative factors. One method that can be used for supplier selection is the Analytical Hierarchy Process (AHP) method. This research was conducted at Manufacturing companies in relations with suppliers who will develop a partnership relationship between companies and suppliers. The purpose of this research is that the right supplier can help the company in increasing competitiveness that can increase company revenue. To help companies choose the right supplier, a decision support system is needed. The variables used in this paper are price, quality, service, delivery accuracy and quantity. The most determining criterion in selecting suppliers is the accuracy of delivery criteria, making these criteria a major factor in supplier selection. The results of this study are consistency in delivering goods on time and guaranteeing safety in guaranteeing the quality of a product.