Objectives: to assess the effect-related inflammatory and coagulation biomarkers in pregnancy and their connection with the coronavirus disease of 2019 (COVID-19). Methods: A prospective case-control study was carried out among normal third-trimester pregnant women admitted to the labor room of Dr. Soetomo General Academic Hospital between January until June 2021. Two classified groups of patients were established in accordance with the result of the RT-PCR test. Demographic, clinical and laboratory results data of the two groups were collected and compared. Results: Platelet-to-lymphocyte ratio (PLR) was shown to be the only significant biomarkers found in the expectant with COVID-19, which was 35.8% higher compared to the ones free of COVID-19 [212.25 (157.57-269.37) vs 156.29 (128.55-195.3), p=0.048]. Logistic regression analysis of PLR between groups showed that the level of PLR was an independent factor in pregnant women with COVID-19 (OR 4.483, 95%CI 1.262-15.926). The ROC analysis showed that the PLR cut-off among the expectant was 171.335, with both sensitivity and specificity were 66.7% (p=0.021). The result shows no significant differences in leukocyte count, absolute neutrophils – lymphocyte count and percentage, neutrophil-to-lymphocyte ratio (NLR) and D-Dimer level between pregnant women infected with COVID-19 and free of the virus (p>0.05). Conclusion: Intriguingly, physiological adaptation during the course of the third trimester of pregnancy found no difference in most inflammation and coagulation markers, both in the condition of infected COVID-19 or not. The evidence from this single-centre study supports the viewpoint that elevated PLR was associated with independent biomarkers and thereby might be helpful to detect expectant with COVID-19.
The need factor-based to the theory of Andersen and Newman (2005) is seen from 2 aspects, which include the individual assessment aspect (perceived need factor) and the clinical aspect (evaluated need). There is still no publication of review research that discusses specific analyzes of subjective assessment of the needs of the elderly on the use of services in health facilities at Puskesmas and Posyandu. The purpose of this study was to identify the relationship between the influence of perceived need factors on the utilization of health services for the elderly at the Puskesmas and Posyandu. This study is a qualitative study with a literature review using quantitative and mixed methods analysis which are published from 2016 to 2021. The collection of literature using the Scopus, Science Direct, PubMed, and Google Scholar databases. The search results obtained 60 articles that matched the keywords and then the overall identification was carried out using inclusion and exclusion criteria in the content of the article so that 12 articles were reviewed. The results showed which variable of perceived need factor that most commonly found to be related to the utilization of elderly health care services at Puskesmas and Posyandu was the chronic condition variable (n = 4 articles), followed by the self-rated health, subjective health complaint, perception for benefit matter and limitation in daily activities variable, each of them are (n=2 articles). Further studies are needed to develop an appropriate instrument in assessing the factors of the needs of the elderly in full, namely the factors of the needs of the elderly which are seen from the clinical aspect of the utilization of health services at the Puskesmas and Posyandu.
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