Background: Inflammation plays an important role in the pathogenesis of COVID-19 and can be an important factor in the prognosis. The innate immune response to a respiratory infection is characterised by an influx of neutrophils to the lungs, particularly the alveoli. A sustained release of anti-inflammatory cytokines may lead to widespread apoptosis of lymphocytes, resulting in lymphopenia. Hs-CRP is an indicator of COVID-19 inflammation. The aim of this study was to analyse Neutrophilto-Lymphocyte Ratio (NLR) and Hs-CRP in order to predict mortality in COVID-19 patients. Research methods: This research was conducted at Moewardi Hospital in July 2020. The subjects were COVID-19 patients. NLR is neutrophils divided by lymphocytes using a haematology analyser. The examination of Hs-CRP was conducted utilizing the ELISA method. Statistical test with an independent T-test and cox proportional hazard analysis with p <0.05 was also used. Results: The results showed that Hs-CRP and NLR increased in COVID-19 patients who later died and obtained lower levels of surviving (p = 0.001 and p = 0.11). Hs-CRP increased the risk of death for COVID-19 patients (p = 0.18; HR = 1.036) and NLR also increased the risk of death for COVID-19 patients (p = 0.08; HR = 1.34) Conclusion: Neutrophil-to-Lymphocyte Ratio and Hs-CRP predicted mortality in COVID-19 patients
<p class="AbstractNormal"><strong>Pendahuluan: </strong>Munculnya virus SARS CoV-2 yang memiliki daya penularan tinggi telah menyebabkan terjadinya pandemi COVID-19 di seluruh dunia<em>. </em>Akibat belum ditemukannya pengobatan definitif dan belum meratanya vaksin untuk seluruh penduduk, maka menerapkan protokol kesehatan sebagai upaya pencegahan sejauh ini merupakan langkah ideal untuk menekan angka kejadian COVID-19. Tujuan penelitian ini adalah untuk menganalisis faktor yang berpengaruh terhadap kepatuhan dalam menerapkan protokol kesehatan melalui pendekatan <em>Health Belief Model</em> (HBM).</p><p class="AbstractNormal"><strong>Metode: </strong>Penelitian ini adalah penelitian deskriptif analitik dengan desain studi <em>cross sectional</em>. Pengambilan data dilakukan melalui survei kuesioner yang diberikan langsung kepada responden. Subjek penelitian ini adalah penduduk Kecamatan Banjarsari berjumlah 100 responden. Penelitian dilakukan pada bulan Mei 2021. Teknik analisis dalam penelitian ini menggunakan uji <em>chi-square</em> (α=0,05) dengan <em>software</em> SPSS versi 21.</p><p class="AbstractNormal"><strong>Hasil:</strong><strong> </strong>Pada uji <em>chi-square</em>, didapatkan hasil bahwa persepsi keparahan (p=0,012), persepsi hambatan (p=0,001), persepsi manfaat (p=0,031), dan isyarat untuk bertindak (p=0,003) berhubungan secara statistik terhadap kepatuhan protokol kesehatan. Sementara persepsi kerentanan (p=0,164) dan efikasi diri (p=0,120) tidak berhubungan secara statistik terhadap kepatuhan protokol kesehatan.</p><p class="AbstractNormal"><strong>Kesimpulan: </strong>Terdapat hubungan antara<strong> </strong>persepsi keparahan, persepsi hambatan, persepsi manfaat, dan isyarat untuk bertindak terhadap kepatuhan protokol kesehatan.</p><p class="Keywords">Kata Kunci: COVID-19, <em>Health Belief Model</em>, Kepatuhan, Protokol Kesehatan.</p>
Pendahuluan: Penyakit Ginjal Kronis (PGK) merupakan sesuatu penyakit yang ditandai dengan terdapatnya kelainan struktural ataupun fungsional pada ginjal yang berlangsung paling sedikit 3 bulan. Terdapat beberapa penyakit atau kondisi klinis yang menjadi etiologi PGK, salah satunya adalah hipertensi. Disfungsi endotel yang menjadi salah satu pemicu dari bermacam penyakit vaskular kronis termasuk hipertensi, menginisiasi produksi dari sebagian sitokin pro-inflamasi yang bisa menimbulkan penekanan eritropoiesis. Sitokin pro-inflamasi pula ikut serta dalam resistensi eritropoietin yang menimbulkan anemia. Anemia pada PGK berhubungan dengan penurunan kualitas hidup, kenaikan penyakit kardiovaskular, kenaikan rawat inap, kendala kognitif, serta kematian. Penelitian ini bertujuan untuk mengetahui perbandingan kejadian anemia pada pasien PGK dengan hipertensi yang terkontrol dan tidak terkontrol. Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan studi potong lintang (cross sectional). Penelitian ini dilakukan di Rumah Sakit Umum Daerah Dr. Moewardi pada bulan Juli-November 2021 dengan jumlah sampel 110 pasien PGK yang sudah memenuhi kriteria inklusi dan eksklusi. Pengambilan data dilakukan dengan menggunakan rekam medis pasien, kemudian data dianalisis secara statistik dengan Uji Chi-Square. Hasil: Berdasarkan analisis Chi-Square didapatkan hubungan yang signifikan (p < 0,001) antara kejadian anemia dengan status hipertensi pada pasien PGK dan perbandingan kejadian anemia pada pasien PGK dengan hipertensi tidak terkontrol dibandingkan hipertensi yang terkontrol adalah 54:10. Simpulan: Kejadian anemia pada pasien PGK dengan hipertensi yang tidak terkontrol lebih tinggi dibandingkan dengan hipertensi yang terkontrol. Kata Kunci: Penyakit Ginjal Kronis; Hipertensi; Anemia.
Introduction: Anthrax is a zoonotic disease caused by Bacillus anthracis which is transmitted to humans from infected animals. Transmission occurs when there is contact with animals or products from animals infected with anthrax. Anthrax infection is an important public health problem in developing countries. Indonesia is one of the countries where zoonotic anthrax forms can still be found. The most common entrance route for anthrax spores is the skin. Although skin anthrax usually resolves on its own, complications can arise in untreated cases. Underlying systemic disorders such as diabetes mellitus can disrupt the clinical picture and cause atypical presentation. Case Presentation: A 50-year-old woman who works as a farmer with a history of diabetes mellitus, is treated at a local hospital with complaints of fever and inflamed lesions in the lower right leg. An anthrax outbreak has been reported in the area where she lives. At clinical examination regional swelling was found and the appearance of blackish lesions accompanied by pus around the wound. Laboratory tests documented by ELISA an increased titre of anthrax antibodies. The patient was given antibiotic therapy with a combination of penicillin G and ciprofloxacin intravenously and experienced healing from skin lesions. Conclusion: Comorbid diseases such as diabetes mellitus can obscure clinical manifestations of skin anthrax and causes systemic symptoms. With appropriate management, skin anthrax lesions in patients with comorbid diabetes mellitus can heal with good results.
(8,13 + 7,62 vs 11,16 + 8,32, p = 0,001), secara signifikan (p <0,001). Kadar IL 6 sebelum dan sesudah pengobatan pada kelompok perlakuan adalah (9,72 + 7,29 vs 6,09 + 3,82, p = 0,002); Menurun secara signifikan (p <0,05). Kesimpulan: Oral NAC menurunkan kadar IL 6 pada pasien CKD stadium V yang menjalani CAPD.Background: IL 6 level is increased in stage V CKD patients on CAPD. N-Acetyl Cysteine is a compound containing thiol with antioxidant and anti-inflammatory effects. Objective: To examine the effect of oral NAC on IL 6 level in stage V CKD patients on CAPD. Methods: An experimental research with Randomized Double Blind Control Trial, involving 30 CKD patients on CAPD in Dr Moewardi Hospital. They were divided into control group/placebo (15 patients) and oral NAS treatment group (15 patients). IL 6 level was measured before and after 8 weeks of treatment. Results : Level of IL 6 before and after treatment in control group were (8.13 + 7.62 vs 11.16 + 8.32 , p= 0,001), significantly (p<0,001). Level of IL 6 before and after treatment in treatment group were (9.72 + 7.29 vs 6.09 + 3.82, p = 0,002); lowered significantly (p<0,05). Conclusion: Oral NAC lowered the level of IL 6 in stage V CKD patients on CAPD.
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