Background Hemophilic arthropathy, a condition manifested as joint destruction due to spontaneous joint bleeding, is one complication of hemophiliac patients. Early detection and intervention may improve the outcome, in which ultrasonography can be an ideal modality with the introduction of HEAD-US (Hemophilia Early Arthropathy Detection with Ultrasound) protocol. Studies have shown US benefit in hemophiliac patients, including its potential as an alternative for the Hemophiliac Joint Health Score (HJHS) system. However, many of the studies were conducted in countries with better management of hemophilia using prophylaxis treatment. It is unclear whether HEAD-US has a correlation with HJHS in countries using episodic treatment only, like in Indonesia. Purpose This study aimed to explore the correlation between HEAD-US and HJHS in hemophiliac patients with joint problems in Indonesia. Materials and methods A cross-sectional correlation study between HEAD-US and HJHS was performed with primary data collected from 120 hemophilic patients. US examination was performed on elbow, knee and ankle joints using the HEAD-US scoring method by a musculoskeletal radiologist. HJHS examination was conducted by a trained physiotherapist and a medical rehabilitation specialist. All examiner is member of multidisciplinary Hemophiliac Management Team in Cipto Mangunkusumo General Hospital in Jakarta, Indonesia. Results The mean age of the participant was 9.3 (5–14) years old. The median score of HEAD-US was 8 (1–28) with most of the joint abnormalities found on the ankles. The median score of HJHS was 3 (0–35), with most joint abnormalities found on the knees. There was a moderate correlation between HEAD-US and HJHS score (p < 0.05, r = 0.65). Conclusion HEAD-US shows a moderate correlation to HJHS in hemophiliac patients who received episodic treatment. HEAD-US can provide additional value in the anatomical evaluation of the joint and could be complementary to HJHS in assessing the joint status in hemophilic patient
The novel coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has become a public health emergency of international concern. The first confirmed COVID-19 case in Indonesia was announced on 2 March 2020, and later on, 11,192 confirmed cases were reported as of 3 May. The World Health Organization has stated that performing a real-time reverse transcription–polymerase chain reaction (RT-PCR) specific for SARS-CoV-2 on specimens from the upper and the lower respiratory tracts, especially nasopharyngeal and oropharyngeal swabs, is the standard diagnostic procedure for COVID-19. In Indonesia, we also use other diagnostic tests, such as rapid antibody tests specific for SARS-CoV-2. Herein, we report an atypical case of COVID-19 and describe the diagnostic process, the clinical course, with progression to severe pneumonia on Week 3 of illness and the case management. We also try to highlight the possibility of false-negative RT-PCR tests.
Background: COVID-19 is a disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that has become a pandemic. It became apparent that COVID-19 transmitting from person to person. The clinical manifestations and characteristics of COVID-19 encompassing from asymptomatic infection until severe pneumonia and death. This study aimed to describe and compare the characteristics between COVID-19 suspected patients and confirmed patients at an early pandemic in Jakarta, Indonesia. Methods: A cross-sectional design was used in this study. Data were collected from March to April 2020 using the electronic health record reporting database, initial laboratory tests, and RT-PCR for SARS-CoV-2 results. There were 58 subjects: 43 COVID-19 confirmed patients and 15 COVID-19 suspected patients. Results: Male was found predominantly in COVID-19 confirmed patients than female. The mean age of confirmed patients was 49,6 years old. Nearly half of the confirmed patients had comorbidities namely hypertension and diabetes mellitus. Fever and cough were the most common presenting symptoms, and they were also found in suspected patients. Confirmed patients tended to have lymphopenia and neutrophilia. Pulmonary infiltrate was the most common feature in both confirmed and suspected patients. Conclusion: There were no significant differences found between COVID-19 confirmed and suspected cases regarding demographic characteristics, comorbidities, presenting symptoms, physical examination results, laboratory tests, and chest x-ray results. COVID-19 confirmed patients had a history of exposure to COVID-19 confirmed patients.
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