Background: Corona virus disease-19 (COVID-19) is a respiratory disease caused by SARS-COV-2 virus. COVID-19 vaccines were designed to produce neutralizing antibody towards the spike (S) protein of the SARS-COV-2 virus. The lymphocyte value has been known to influence the effectiveness of the vaccine. This research was conducted to assess the relationship between the lymphocyte value and the neutralizing antibody titer in residents of internal medicine in Faculty of Medicine, Universitas Sumatera Utara, who had received COVID-19 vaccination. Method: This was an observational analytic study with cross-sectional design, conducted since February to May 2022. The research was performed on residents of internal medicine who had received COVID-19 vaccination. The lymphocyte value was based on the complete blood count, while the neutralizing antibody titer was based on the IgG-SARS-COV-2 titer that was measured using chemiluminescent immunoassay. The data was collected and analyzed using SPSS version 26. Results: There were a total of 45 research subjects included in the study. The mean value of lymphocyte was 31.28% with a mean value of absolute lymphocyte count(ALC) of 2437.99. The mean value of IgG-SARS-COV-2 was 13864.44 AU/ml. The correlation test between lymphocyte value and IgG-SARS-COV-2 titer using Spearman correlation showed a p-valued of 0.476. Conclusion: There was no significant relationship found between the lymphocyte value and the neutralizing antibody titer in residents of internal medicine in Faculty of Medicine, Universitas Sumatera Utara who had been vaccinated (p-value 0.476). Keywords: Lymphocyte, Neutralizing antibody, IgG-SARS-COV-2, Internal Medicine Residents
Background: Male hypogonadism is a clinical disorder of low testosterone and spermatozoa due to impaired production that can occur at one or more levels in the hypothalamic-pituitary-gonadal (HPG) axis. Apart from iron accumulation, hypogonadism can also occur due to other mechanisms in thalassemia patients, such as the influence of adipose tissue and leptin. The study aimed to assess the relationship between leptin with free testosterone levels and BMI in transfusion-dependent thalassemia. Method: The research design chosen was analytic cross-sectional. The study was conducted at the adult thalassemia polyclinic of Cipto Mangunkusumo General Hospital and Fatmawati General Hospital, during the period July - December 2022. The samples used were male transfusion-dependent thalassemia patients aged over 18 years who were under control at the Thalassemia Polyclinic during the study period. The diagnosis of Thalassemia had been previously established by high-performance liquid chromatography (HPLC) or microcapillary examination. Result: Most patients were major ß thalassemia (87.8%), while HbE ß thalassemia was only 12.1%. Age distribution was with a median of 23 years (minimum-maximum 18-42 years). The clinical symptoms of hypogonadism were erectile dysfunction and decreased libido (12.1% and 9%, respectively). From body mass index examination were underweight 18 (54,5%), normal weight 13 (39,5%), overweight 1 (3%), and obese 1 (3%). Of the 33 transfusion-dependent thalassemia patients, 95% did not reach puberty according to their age (Tanner stage V). Conclusion: There is an association significantly between leptin levels with free testosterone and body mass index in transfusion-dependent thalassemia men.
Covid-19 diagnosis generally uses RT-PCR as the gold standard to detect coronavirus-2 (SARS-CoV-2); however, this method requires advanced laboratory equipment. Alternatively, Neutrophil-Lymphocyte Ratio (NLR) and Lymphocyte-Monocyte Ratio (LMR) can be used to identify viral infection. The study aimed: (1) to compare each NLR and LMR ratio in patients with and without COVID-19 and (2) to test the effectiveness of these ratios in identifying COVID-19. The study was conducted at the Haji Adam Malik Central General Hospital by acquiring 87 medical records data. The complete hematologic profile was analyzed from patients with and without COVID-19. The NLR and LMR ratio accuracy were analyzed as a screening tool for COVID-19. The AUC of NLR was 0.638, with cut-off ≤ 2.49, 47.6% sensitivity, and 80% specificity; therefore, the NLR accuracy as a screening for COVID-19 was defined as not good (just sufficient) because of AUC <0,7. The AUC of LMR was 0.661, with cut-off ≥ 3.23, 45.2% sensitivity, and 82.2% specificity; therefore, the LMR accuracy as a screening parameter for COVID-19 is defined as not good (just sufficient) because of AUC <0,7. There were significant differences in hematologic profile in neutrophil, lymphocyte, NLR, LMR between the patients in the COVID-19 group and non-COVID-19 group. NLR and LMR cannot be used as a screening tool because the Area Under Curve (AUC) is not good enough (just sufficient) in detecting COVID-19.
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