It is important to predict the severity of COVID-19 during the pandemic. Both Neutrophil Lymphocyte Ratio (NLR) andAbsolute Lymphocyte Count (ALC) are two easy, low-cost, and fast inflammatory markers, which positively correlate with theseverity of COVID-19. The purpose of this research was to analyze the value of NLR and ALC as predictors of COVID-19severity. This research was a retrospective study using medical record data of 376 COVID-19 patients duringApril-September 2020 at the Hasanuddin University Hospital and Makassar City Regional Hospital. Patients were classifiedinto non-severe and severe COVID-19. Neutrophil lymphocyte ratio and ALC values were determined based on routineblood test (Sysmex XS-800i) results, statistical analysis using Independent T-test, while NLR and ALC diagnostic values wereanalyzed with Receiver Operating Characteristics (ROC) curve to obtain the cut-off value, p < 0.05 was significant. Thesamples consisted of 372 non-severe and 49 severe COVID-19 patients. Neutrophil lymphocyte ratio value in non-severe(4.02±5.22) was significantly different from severe COVID-19 (9.81±7.06) (p < 0.001), similar to ALC in non-severe(2.00±0.83x103/μL) and severe COVID-19 (1.22±0.78x103/μL) (p < 0.001). Receiver operating characteristics curve showedthat NLR had a sensitivity of 91.8% and specificity of 66.4% with a cut-off ≥ 3.17 with Negative Predict Value (NPV) of 98.2%and Positive Predict Value (PPV) of 29.0%; while ALC had a sensitivity of 81.6% and specificity of 64.8% at cut-off≤ 1.74x103/μL with NPV of 95.9% and PPV of 25.8%. Increased NLR and decreased ALC in severe COVID-19 patientsoccurred due to an increased inflammatory response resulting in a decreased cellular immunity. Receiver operatingcharacteristics curve showed a cut-off for NLR of 3.17 and ALC of 1.74x103/μL, indicating an optimum sensitivity andspecificity. It was concluded that NLR and ALC can be used as predictors of COVID-19 severity with a cut-off ≥ 3.17 and≤ 1.74x103/μL, respectively.

No abstract

We examined mutations in the forkhead transcription factor gene, FOXL2, in three members of a Japanese family with autosomal dominant blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) and in 100 healthy controls. The FOXL2 was analyzed by direct genomic sequencing. A novel 17-bp deletion at nucleotides 1092-1108 in FOXL2 was found in the three affected patients. No mutation was found in any of the 100 healthy controls. The 17-bp deletion in FOXL2 may be involved in the pathogenesis of BPES in Japanese patients.

No abstract

The COVID-19 incidence is increasing around the world. Some countries are experiencing worsening conditions, evendeaths. One coagulation marker that noticeably increases in COVID-19 patients is D-dimer. This study aimed to analyzeD-dimer levels of COVID-19 patients. Retrospective study using medical records of 84 COVID-19 patients, conducted fromApril to August 2020 at UNHAS Hospital. Patients were grouped based on the severity of the disease as non-severe andsevere. D-dimer levels were measured using the Alere Triage® D-dimer with the fluorescent immunoassay method. Thestatistical test used was Mann-Whitney, D-dimer prognostic levels were calculated with ROC analysis to get the cut-off.Significant if the p < of 0.05. The sample consisted of 74 non-severe and ten severe COVID-19 patients, mostly in the 30-39age group. D-dimer levels in non-severe (0.31±0.38 μg/L) significantly differ from severe group (3.09±2.56 μg/L) (p<0.001).The Receiver Operating Characteristics (ROC) curve showed D-dimer sensitivity and specificity of 90.0% and 89.2%,respectively at the ≥ 0.80 μg/L cut-off, Negative Predictive Value (NPV) of 98.5%, and Positive Predictive Value (PPV) of52.9%. D-dimer levels increased in severe COVID-19 patients due to an increased inflammatory response resulting inexcessive thrombin. The ROC D-dimer curve indicated a cut-off rate of 0.80 μg/L, providing optimal sensitivity andspecificity. D-dimer has a significant difference in non-severe and severe COVID-19 patients and shows good value todetermine the severity of COVID-19 disease with a cut-off value ≥ 0.80 μg /L.

AbstractIntroduction. The prevalence of obesity is increasing worldwide in high, low, and middle-income countries such as Indonesia. Obesity rate is higher in females in Indonesia. Obesity has important contribution in the occurrence of insulin resistance (IR) and type 2 diabetes mellitus. Several anthropometric measurements such as waist circumference (WC), body mass index (BMI), body mass (BM), total body fat percentage (Fat%) and visceral fat (VF) are related to IR. This study aimed to investigate which of those measurements could be used as a better predictor of IR in non-menopausal Indonesian adult females.Methods. Total of 80 non-menopausal Indonesian adult females ranging from 21-40 years were recruited in this study. Insulin resistance was measured by using Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) equation. Subjects with HOMA-IR index >75th percentile with cut-off 2.74 were defined as IR. Waist circumference, BMI and BM were measured, while TF and VF were measured by bioelectrical impedance analysis (BIA).Results. HOMA-IR had significant correlation with WC (r = 0.563, p<0.001), BMI (r = 0.537, p<0.001), BM (r = 0.515, p<0.001), VF (r = 0.515, p<0.001), Fat% (r = 0.490, p<0.001). The area under curve of VF (0.809), BMI (0.807), WC (0.805), and BM (0.799) are slightly larger than and Fat% (0.766).Conclusion. Insulin resistance had strong correlation with all anthropometric measurements, but the correlation was less significant with Fat%.

About 70% of all nosocomial infections occur in surgical patients. In open fracture, there is contact with the environment or unsterilebody compartment, so that bacterial contamination may occur and cause infection. Besides debridement, prophylactic antibiotics havebeen used as a standard procedure in the open fracture management. This procedure may cause antibiotics resistance leading to increasethe number of infections. The aim of this retrospective study was to know the characteristics, microbial pattern, and sensitivity of 35cultures and sensitivity test of open fracture patients in Orthopaedics Department of Wahidin Sudirohusodo Hospital during the period ofJune 2009–June 2010. The most common bacteria found were Proteus mirabilis (26%), Klebsiella pneumonia (14. 8%), and Providenciaalcalifaciens (14%). The sensitivity test for antimicrobials showed that most of the 19 antimicrobials, were resistant. The sensitiveantimicrobial is Meropenem.

The reference values of laboratory tests are affected by factors such as instruments and methods of tests, which are always beingdeveloped. For these reasons, each laboratory is recommended to determine their own reference values. To determine the reference valuesof complete blood count in healthy adult people, and compare them to the reference values which is taken from the references. A crosssectional study was conducted on 200 healthy adult people, aged 18-60 years, selected during blood donation. The eight haematologicalparameters were estimated using Sysmex Xt-1800i at Dr.Wahidin Sudirohusodo Hospital. The data were analyzed statistically by SPSS11.5 programs. The reference values of leukocyte, erythrocyte, haemoglobin, hematocrit, MCV, MCH, MCHC and platelet were: 4400 to10000 /µL; %:4.2–6.2 × 106/µL; &:3.8–5.5 × 106/µL; %:12.5–17.3 g/dL; &:11.8–15.4 g/dL; %:38.1–50.4 %; &:31.1–49.7 %; 80,1to 94,3 fL, 25,9–31,9 pg, 31,4–35,2 g/dL, and %:171.2–405.1 × 103/µL; &:191.8–441.5 × 103/µL, respectively. Significant differenceswere observed in the MCH and platelet values (p< 0,005). The values found in this study were similar to the reference value commonlyused in our laboratory, except for the MCH value which was lower and the platelet value which was higher..