Background. Acquired immunodeficiency syndrome (AIDS) is caused by the Human immunodeficiency virus (HIV) infection and characterized by a progressive decrease in the immune system function which eventually leads to the development of opportunistic infections and other complications. In order to monitor the disease progression the CD4 examination and additional Complete Blood Count (CBC) were commonly used.Objectives. To determine the correlation of total lymphocyte count, hemoglobin level, lymphocyte/leukocyte ratio (LLR) and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with HIV infection.Methods. This a retrospective cross-sectional analytic study conducted from July to August 2017. The total lymphocyte count, hemoglobin level, lymphocyte/leukocyte ratio (LLR) and lymphocyte/neutrophil ratio (LNR) and CD4 level were measured in the study. The data normality and the correlation were analyzed using the Kolmogorov-Smirnov test and the Pearson Correlation test, respectively, performed in SPSS version 14. The p-value less than 0.05 was considered significant for the results.Results. A total of 60 samples conducted CD4 and complete blood counts (CBC) examinations during the period July-August 2017. The mean CD4 levels were 341.73 ± 243.48 cells/µL, the total leukocyte count was 6.98 ± 2.93 x 103/µL, the total lymphocyte count was 2.09 ± 0.87 x 103/µL, hemoglobin level 13.38 ± 2.09 g/dL, lymphocyte/leukocyte ratio (LLR) 0.31 ± 0.11, lymphocyte/neutrophil ratio (LNR) 0.67 ± 0.40. Statistical analysis showed that data is normally distributed. Pearson correlation analysis showed that there was a significant relationship between CD4 levels with total lymphocytes counts, hemoglobin levels, RLL, RLN with correlation coefficients of 0.571 (p = 0.000), 0.324 (p = 0.012), 0.509 (p = 0.000), 0.463 (p = 0.006), respectively. There was no significant correlation between CD4 levels and total leukocytes with a correlation coefficient of 0.171 (p = 0.19).Conclusion. There is a positive correlation between CD4 levels and total lymphocytes, hemoglobin levels, RLL and RLN in patients with HIV at Sanglah Hospital.
Completeness of laboratory critical values reporting and documentation in medical records is important for patient safety, hospital accreditation, and legality. Preliminary study in Dr. Soetomo Hospital’s ward showed the laboratory critical value report and documentation was 0% complete, 4% incomplete, and 96% undocumented. This was a quasi experimental study with one group pretest and posttest design. Technical guidance of laboratory critical values reporting and documentation in medical records and supervision were given to 26 doctors. The results evaluated were doctor knowledge and attitude towards critical value reporting, completeness of documentation in medical records, and turn around time (TAT). Reporting critical values samples number was 72 before and after the intervention. The critical values samples taken by purposive sampling. The data was analyzed using Mann-Whitney test. There were significant differences in the level of knowledge, doctor’s attitudes, and completeness of critical values documentation before and after the intervention. Doctors with good knowledge increased from 3.85% to 92.31%. The attitude to complete critical values documentation improved from 0% to 76%. Completeness of critical values documentation in medical records improved from 100% undocumented to 19.44% undocumented, 11.11% incomplete, and 69.45% complete. There were no significant differences of TAT before and after the intervention, all of TAT were less than 30 minutes and meeting the TAT category. The intervention succeeded in increasing doctor knowledge, attitude, and completeness of the laboratory critical values reporting and documentation in the patient's medical record. Keywords: Laboratory critical value, medical record, turn around time.
Background: COVID-19 pandemic causes severe acute respiratory syndrome and requires rapid action. The development of effective safe vaccines become a global priority for achieving herd immunity. Vaccination is expected to form specific antibodies against the SARS-CoV-2 spike protein which can neutralize the virus, preventing the virus from binding with ACE 2 receptors. Objective: Evaluating and to know if there any differences of kinetics antibody levels from recipient’s anti-IgG S-RBD and NAb with complete second dose CoronaVac Vaccine, to determine the antibody response in preventing SARS-CoV-2. Method: A prospective-cohort study using observational analytics was conducted from January-April 2021 at Dr. Soetomo Hospital, Surabaya. A total of 50 subjects are healthcare workers who received two doses of CoronaVac. The IgG S-RBD and NAb levels were measured on Maglumi 800 device (SNIBE, China). Differences in IgG S-RBD and NAb levels before vaccination and after second dose CoronaVac vaccination on 14th day, on 28th day, ware tested using Friedman and Wilcoxon tests. Result: Mean values of IgG S-RBD and NAb have fluctuated. There was a significant difference between IgG S-RBD and NAb levels on day-0 (0.090 vs 18.630; p < 0.001) and day-28 (141.266 vs 116.640; p = 0.037). The median value showed the IgG S-RBD level on day-28 was much better than NAb value (141,266 v 116,640). Conclusion: CoronaVac will form persistent antibodies. Despite antibody development, the acquired humoral immunity decreased at 28 days after full CoronaVac immunization. Kinetics of antibody NAb decreased more rapidly than IgG S-RBD.
Background: Coronary heart disease (CHD) is a leading cause of death worldwide. One type of CHD that most often causes clinical manifestations and death is Acute Coronary Syndrome (ACS). In 2013 the prevalence of SKA in Indonesia reached 1.5% and it is estimated that it will continue to increase every year. Objective: This study aims to determine the profile of major risk factors for ACS sufferers in the Pusat Pelayanan Jantung Terpadu (PPJT) Dr. Soetomo Public Hospital Surabaya in the period January-December 2019. Methods: This study used a retrospective descriptive method to analyze the patient's electronic medical record (e-MR). Results: Out of 623 patients diagnosed with ACS, 429 were excluded from the research. 194 patients who met the inclusion criteria were studied with the following details: 19 APTS patients, 43 N-STEMI patients, and 132 STEMI patients. It was found that 73% of ACS patients were male, with the 55-64 years’ age group dominating by 46%. Based on blood pressure and serum cholesterol examination data, it was found that 51% of patients had hypertension and 77% of patients had dyslipidemia (40% hypercholesterolemia, 42% hypertriglyceridemia, 40% low HDL-C levels, and 34% high LDL-C levels). 60% patients had type-2 diabetes mellitus and 52% of patients had a history of smoking. Conclusion: 73% of ACS patients in this study were men. Most common age groups were 55-64 years old (46%), had hypertension by 51%, had dyslipidemia by 77% (40% hypercholesterolemia, 42% hypertriglyceridemia, 40% low HDL-C levels, 34% high LDL-C), had type-2 diabetes mellitus by 60%, and had a smoking history by 52%.
Introduction: Laboratory is a place for the analysis of a material that aims for research, education, quality testing and diagnose diseases. Working in the laboratory will always be faced with a variety of risk and sources of danger that can cause workplace accidents. The purpose of this study was to determine the hazards, hazard identification, risk identification, risk assessments, risk control, and residual risk in working at the clinical pathology laboratory. Method: Data collection method used was observational and descriptive research. When viewed from the time of the study, this study was cross sectional. The data used were primary and secondary data, in which the primary data were obtained by direct observation on site, while secondary data were obtained from SOPs available in the laboratory. Results: The results of the study can identify as many as 9 hazards. In the assessment of risk, it obtained the highest level of danger which was high risk. The level of risk was as high as 3 hazards including needling, splattered patient samples, and reagents or hazardous substances. Conclusion: The conclusion from the study is that this laboratory is classified as dangerous because it finds some of the highest risk levels, which is high risk. The existing risk control in this laboratory is quite complete and good, but it needs to be an improvement in terms of compliance in wearing Personal Protective Equipment (PPE) to minimize the risk.Keywords: clinical pathology laboratory, hazard identification, risk assessment
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