Background The prevalence of low birth weight (LBW) is still

Even after more than a year, novel Coronavirus disease-19 (COVID-19) clinical presentation and complications are still being reported. We present a 75-year-old patient with culture-negative pleural empyema a month after COVID-19 resolution without re-infection. We hypothesize that culture-negative empyema can be present in patients with immune defect, e.g., elderly or diabetic patients, and prior antibiotic exposure. Empyema after COVID-19 resolution may be related to delayed inflammation improvement in chronic disease, which resulted in the patient's more vulnerability to secondary infection.

AbstrakLatar belakang: Peningkatan jumlah sindrom metabolik (MetS) (OR 12,13; 95% CI 2,46; p = 0,001), tekanan darah tinggi (OR 9,33; 95% CI 2,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)56; p = 0,001), HDL rendah (OR 8,33; 95% CI 2,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)05; p = 0,003), and glukosa puasa terganggu (p = 0,03) . Empat subjek mempunyai FRS ≥ 1% dan 66 subjek berisiko < 1%. Peningkatan FRS tidak berhubungan dengan MetS (p = 0,154). Tidak ada komponen MetS berhubungan dengan peningkatan FRS. Kesimpulan: Prevalensi MetS pada dewasa muda dengan obesitas hampir sama dengan pada anak-anak dan remaja dengan obesitas. Walaupun tidak didapatkan hubungan antara MetS dan FRS, keduanya merupakan AbstractBackground: The increase number of the metabolic syndrome (MetS) among young adults was mostly caused by obesity. MetS increases the risk of coronary heart disease (CHD) which can be estimated by Framingham risk score (FRS). The study was aimed to know the prevalence of MetS and FRS in obese young adults and to associate them with the components of MetS.

Abstrak Latar belakang: Mengkonsumsi obat antiretrovirus dapat mengurangi morbiditas dan mortalitas orang dengan HIV/ AIDS (ODHA). AbstractBackground: Highly active antiretroviral therapy (HAART) can reduce morbidity and mortality of HIV-infected patients. However, it depends upon adherence to medication. The objective of this study was to examine the adherence to HAART and to evaluate individual patient characteristics i.e. self-effi cacy, depression level, and social support and to fi nally determine HAART adherence in selected regions in Indonesia. Methods: This cross-sectional study was conducted in Jakarta, Malang, Bandung, Makasar and Banda Aceh. The subject of the study was HIV-infected patients who were older than 13 years old and had taken HAART for at least a month. They were recruited consecutively then asked how many pills they had missed during the previous month. Poor adherence can be stated if the percentage of adherence rate is below 95%. HIV treatment adherence self-effi cacy scale (HIV-ASES), Beck Depression Inventory (BDI-II) and Interpersonal Support Evaluation List (ISEL) was adapted to assess self-effi cacy, depression level and social support, respectively. Results: We found that 96 % (n=53) of the subjects adhered to HAART. There were no associations between adherence with self-effi cacy, depression level, and social support. The main cause of non-adherence in this study was 'simply forget'. Conclusion: Adherence to HAART was found to be high and not associated with self-effi cacy, depression level and social support in some central regions in Indonesia. (Med J Indones 2011; 20:50-5)

Arteriovenous fistula is the best permanent vascular access for hemodialysis (HD). However, in our country, HD catheter in jugular or subclavian vein is more commonly found because our patients prefer to hold HD until the complications are unbearable. The catheter increases risk of venous stenosis on site and in surrounding vessels, resulting in access loss. Percutaneous transluminal angioplasty (PTA), combined with stent deployment, can be utilized as main treatment for such stenosis in subclavian vein. This method dated back to two decades ago with high success rate. Nevertheless, reports or studies of angioplasty in total occlusion are scarce, mainly because of lower success rate and the need of smaller penetrating wire. We describe our experience in performing PTA and stent deployment using coronary wire to penetrate total occlusion in subclavian venous stenosis after vein cannulation. We hope that we can give an alternative technique to avoid surgery in such cases.

BACKGROUND: Percutaneous coronary intervention (PCI) is the most common intervention for coronary artery disease (CAD) with very low complications. High oxidative stress post-PCI is associated with further atherosclerosis progression. Curcumin, extracted from a specific type of herbs, exhibits anti-oxidant properties by acting as hydrogen and electron donor for superoxide radicals. The aim of this study is to determine the effect of curcumin’s antioxidant properties in reducing oxidative stress of post-PCI in stable CAD.METHODS: This study was a double-blind parallel randomized controlled trial among 50 stable CAD patients undergoing PCI in Cipto Mangunkusumo General Hospital and Jakarta Heart Center. The subjects received either 45 mg/day curcumin or placebo 7 days pre-PCI until 48 hours post-PCI. Reduced oxidative stress markers (decreased MDA or increased GSH) were measured in 3 phases (7 days pre-PCI, 24 hours post-PCI, 48 hours post-PCI).RESULTS: Curcumin group showed increased MDA from baseline to 24 hours (Δ1=0.01 vs. 0.03; p=0.3) and decreased MDA from baseline to 48 hours (Δ2=-0.06 vs. 0.03; p=0.9). While, curcumin group showed decreased GSH from baseline to 24 hours (Δ1=-49.7% vs. 12.2%; p=0.4) and from baseline to 48 hours (Δ2=-19.09% vs. 11.4%; p=0.6). However, no significant changes were found in malondialdehide (MDA) and glutathione (GSH) level after the intervention.CONCLUSION: The 45 mg/day curcumin supplementation from 7 days pre-PCI until 48 hours post-PCI had no significant antioxidant effect in stable CAD post-PCI.KEYWORDS: coronary artery disease, curcumin, antioxidant, percutaneous coronary intervention

Background. Patent foramen ovale (PFO) is a part of atrial septal defects (ASD) entities. While mostly asymptomatic, some adults with PFO will develop symptoms, from mild complaints such as migraine or palpitation to more debilitating complications such as syncope or cryptogenic stroke. Therefore, it is highly crucial that PFO be diagnosed and treated promptly. Echocardiography, trans-thoracal and or trans-esophageal, is the main diagnosis modality. For treatment, antiplatelet with or without anticoagulation, trans-catheter closure, and surgery are utilized in accordance with their indications. Case Presentation. We present four adult patients referred with various symptoms: vertigo, migraine, palpitation, and cryptogenic stroke. Three of them had no explicit risk factors for the cerebrovascular event, with one patient having a co-existing hypercoagulable state. Echocardiography revealed a positive bubble test, which meant that PFO was the primary etiology of those cases. We then treated each of them with transcatheter device closure, which improved their symptoms, before adding antiplatelet for six months. Conclusion. Proper diagnosis and prompt treatment of PFO are imperative in reducing complications. Echocardiography, mainly TEE, is the main diagnostic tool for PFO. Antithrombotic (with or without anticoagulant), minimally invasive procedure and surgery in some cases are the modalities available.

ABSTRAK p = 0,048). Adapun lama DM,[2][3][4][5][6][7][8][9][10][11][12][13] p = 0,976), obesitas (37% vs 38%, p = 0,897), usia (53,2 ± 10,5 vs 54,7 ± 9,3, p = 0,481) ABSTRACTBackground: One of the most neglected complications of diabetes mellitus (DM) is gastro-esophageal reflux disease (GERD) which arises from autonomic neuropathy and diabetic gastropathy related to the extent of DM. This study was done to find prevalence of GERD in DM patients with GERD-questionnaire (GERDQ), dietary factor proportion, and their association with other GERD risk factor in rural area.Methods: This cross sectional study was conducted in Puskesmas Pelaihari from August to September 2013. Subjects with DM aged ≥ 18 were selected consecutively from both newly and previously diagnosed patients with exclusion criteria: pregnancy, in proton-pump inhibitor therapy, and had other metabolic disease(s). DM was diagnosed with ADA criteria, while GERD was diagnosed in patients with score of ≥ 8 of Indonesian GERDQ.Results: There were 30 subjects (29.7%) with GERD among 101 patients with DM and dietary factors found in GERD patients were spicy diet (90%), high-fat food (90%), irritative beverages (87%), and irritative diet (23%). Only female gender was associated with GERD vs non-GERD in DM patients (87% vs 68%, p = 0.048). Meanwhile, duration of DM (2 [0-13] vs 2 [0-19], p = 0.976), obesity (37% vs 38%, p = 0.897), age (53.2±10.5 vs 54.7 ± 9.3, p = 0.481), and uncontrolled diabetes (90% vs 94%, p = 0.421) were not associated with the GERD among DM patients. Conclusion:Prevalence of GERD in DM is somewhat high in this study. Female group with DM needs to be screened for GERD as early as possible.