bluuebunny/crossref_metadata_2025 huggingface dataset:
PROPORTION OF ISOMORPHIC ERYTROCYTE URINE IN DIABETIC KIDNEY DISEASE WITH FLOW CYTOMETRY METHODS
Authors: Catarina Erica , Rita Coriejati , Andriyoko Basti , Parwati Ida
Published: April 2019

Hematuria can be found in diabetic kidney disease. Urinary erythrocytes morphology can differentiate hematuria in diabetic kidney disease from other glomerular disorders. Different etiologies need different management. Urinalysis with flowcytometry method can directly give information about urine erythrocyte morphology which is not obtained by the conventional method. The aim of this study was to determine the proportion of urinary isomorphic erythrocytes in diabetic kidney disease. This was a descriptive cross-sectional study in the Dr. Hasan Sadikin Hospital Bandung from July 2016 to July 2017. Subjects were 38 patients who have been diagnosed as diabetic kidney disease by clinicians and had hematuria. Random urine samples were collected for erythrocytes morphology assay by using flowcytometry method and u-ACR values by using spectrophotometry method. The result of this study was 57.9% male, with the most frequent age were 55-64 years old group (34.2%) and 63.2% from all subject were included in the macroalbuminuria category. In erythrocyte morphology assay, 84.2% was isomorphic erythrocyte which 83.3% was macroalbuminuria group. The proportion of hematuria in diabetic kidney disease with automated integrated urine flowcytometry method was dominated by isomorphic erythrocyte morphology. Isomorphic erythrocytes in DM did not mean absence of glomerular abnormalities.
ANALYSIS OF RET-HE IN CHRONIC KIDNEY DISEASE PATIENTS AT DR.WAHIDIN SUDIROHUSODO HOSPITAL, MAKASSAR
Authors: Rovani Febrina , Nurulita Asvin , Arif Mansyur
Published: April 2019

Anemia, the common feature of Chronic Kidney Disease (CKD), is a multifactorial process due to disordered erythropoiesis and iron homeostasis. Determining the cause of anemia is important for adequate management. A bone marrow biopsy using Prussian Blue as the gold standard for diagnosis is invasive and more complicated to perform. Reticulocytes-Hemoglobin (Ret-He) a new parameter that indicates the hemoglobin content in reticulocytes is faster, easier, and less expensive. This study aimed to analyze the Ret-He in determining the iron status in patients with CKD. A cross-sectional study was held in the Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo Hospital Makassar during April-August 2016. Forty-five (45) samples were tested for iron serum (Fe), Total Iron Binding Capacity (TIBC), and Complete Blood Count (CBC) ordered by the physician. Reticulocytes-Hemoglobin was tested using the whole blood. Subjects were around the age of 19-71 years, no significant difference was found between numbers of males and females (46.6% and 53.3%). Hemoglobin median was 8 (5.0-15) g/dL, Fe 50 (6-177) U/mL, TIBC 183 (73-379), Transferrin Saturation (Tsat) 25 (5-95)%. Spearman correlation test method showed significant correlations between Ret-He and iron serum r=0.533, p <0.001, Ret-He and TIBC r=0.321 p=0.031 Ret-He and transferrin saturation r=0.416 p=0.019. The Mann-Whitney method showed no significant difference of Ret-He in both groups (Tsat <20% and >20%). There were significant correlations between Ret-He and iron, Ret-He and TIBC, Ret-He and transferrin saturation. A further study using larger samples is suggested to consider factors affecting the result of Ret-He.
ANALYSIS OF RED BLOOD CELL DISTRIBUTION WIDTH COEFFICIENT OF VARIATION ON STROKE PATIENT
Authors: Paramita Kartika , Abdullah Agus Alim , Arif Mansyur
Published: April 2019

Stroke is a functional disorder attributed to acute focal or global brain injury by vascular cause and persists more than 24 hours. Stroke is divided into ischemic and hemorrhagic strokes. Red Blood Cell Distribution Width (RDW) is a measurement of erythrocyte volume variation in blood circulation. Increased RDW reflects the inflammation that plays a role in the development of atherosclerosis in stroke. This study aims to analyze differences in RDW-CV values in patients with stroke. The design was cross-sectional with a retrospective approach, secondary data from medical records of inpatients with stroke from January to December 2016 at the Dr. Wahidin Sudirohusodo Hospital. The study population consisted of 490 patients aged â‰¥ 18 years old. The Kruskal-Wallis, Mann-Whitney, and Anova one way tests were used to analyze differences in RDW-CV values in patients with ischemic and hemorrhagic stroke. Mann-Whitney test results showed no significant difference in RDW-CV values between groups of ischemic and hemorrhagic stroke (p 0.96). Kruskal-Wallis and Anova one way tests showed no significant difference in RDW-CV values between four groups of patient outcomes in ischemic and hemorrhagic stroke (p 0.13 and p 0.35 consecutively). There were no significant RDW-CV values between ischemic and hemorrhagic stroke. There was no significant difference between RDW-CV values of four groups of patient outcomes in ischemic and hemorrhagic stroke. RDW-CV values cannot be used to distinguish both ischemic and hemorrhagic stroke, including the prediction of stroke mortality
IgA ANTI-DENGUE PROFILE IN SAMPLES WITH POSITIVE DENGUE PCR OR NS1
Authors: Ramadhani M Thohirin , Aryati Aryati , Arfijanto M Vitanata
Published: April 2019

Dengue Virus Infection (DVI) causes several clinical manifestations and requires varied diagnostic instruments. IgA anti-dengue as one of the diagnostic markers of DVI is suspected to have a shorter lifespan and greater sensitivity in detecting secondary infections compared to IgM anti-dengue. This study was conducted using 34 sera with positive RT-PCR or NS1 dengue virus. Samples were examined by a reverse flowimmunochromatographic method using AIM Dengue IgA Assure Rapid Test and will be analyzed its profile toward the day of fever, serotype, severity, platelet count, and type of infection. The overall sensitivity of IgA anti-dengue was 61.76% (n=34); in which IgA anti-dengue detected 14.29% primary and 66.67% secondary cases. IgA anti-dengue detected DEN1, DEN2, DEN3, and Mixed DEN1 – DEN3 virus serotype respectively 55.56%, 22.22%, 16.67%, and 5.56% (n=20). The day of fever was dominated by day-4 and day-5 respectively 28.57% (n=21). IgA anti-dengue was detected in DD, DHF grade I, II, and III 42,86%, 28.57%, 19.05%, and 9.52% (n=21) respectively. IgA anti-dengue detected in all levels of platelet count, it detected 60% in < 50,000 cell/mm3, 30% in 50,000 - 100.000 cell/mm3 and 10% in > 100,000 cell/mm3 platelet count sample (n=20). In conclusion, IgA anti-dengue showed a good performance, applicable as a diagnostic marker of DVI.
THE ASSOCIATION OF INSULIN RESISTANCE AND LIPID PROFILE RATIO IN METABOLIC SYNDROME
Authors: Rahmayani Rini , Aman Adi Koesoema , Safril Santi
Published: April 2019

The cause of metabolic syndrome is still not known for sure, but it is suspected that the pathophysiology of metabolic syndrome is associated with insulin resistance and central obesity. Researchers have attempted to evaluate insulin resistance using various serum lipid concentration ratio. This study was to observe the association between insulin resistance and lipid profile ratio using HOMA-IR in metabolic syndrome patients. This study was a cross-sectional that was conducted in Inpatient and Outpatient Adam Malik Hospital during March 2016 - April 2016. Subjects were patients with metabolic syndrome criteria according to the International Diabetic Federation 2005. All samples were examined for their waist circumference, weight, height, blood pressure, insulin, serum glucose, total cholesterol, HDL cholesterol, LDL cholesterol, Triglycerides. Among sixty-six patients in the study 40 (60.6%) were male and 26 (39.4%) female. In this study, there was a significant correlation between HOMA-IR with CT/HDL ratio (r: 0.244 p <0.05); and there was no correlated HOMA-IR, and TG/HDL ratio (r: 0.086 p > 0.05) and there was no correlation between HOMA-IR and LDL/HDL (r: 0.336 p > 0.05). There was a significant relationship between insulin resistance and ratio CT/HDL
CORRELATION OF LIPID PROFILE WITH INTERLEUKIN-12 IN TYPE 2 DIABETES MELLITUS
Authors: Sari Meri Ponda , Maani Hanifah , Nasrul Ellyza , Rofinda Dia
Published: April 2019

Dyslipidemia is one of the common disorders in the diabetes mellitus (DM) patients causes cardiovascular disorders. Interleukin-12 (IL-12) is an important inflammation cytokine and elevated in type 2 DM (T2DM) which may contribute to inflammation of atherosclerotic plaque formation. Hyperglycemia, hyperlipidemia, hyperinsulinemia and oxidative stress that lead to endothelial dysfunction of atherosclerotic. The aim of this study to determine the correlation of lipid profile with IL-12 in T2DM. This study was an analytical study with cross-sectional design in 30 patients T2DM meet the inclusion and exclusion criteria and conduct blood tests at the Central Laboratory Installation of Dr. M. Djamil Hospital Padang in September 2016-August 2017. Level of lipid profile performed by the enzymatic colorimetric method. Sandwich ELISA used to measure the level of IL-12 in Biomedical Laboratory Medical Faculty of Andalas University. Spearman correlation was used, significant if p<0,05. The mean levels of total cholesterol, high-density lipoprotein, (HDL), triglycerides and low-density lipoprotein (LDL) in T2DM were  204.2 ± 42.8 mg/dL; 46.8 ± 9.3 mg/dL; 57 ± 53.4 mg/dL; 132.97 ± 41.0 mg/dL. The mean level of IL-12 in T2DM is 160.15 ± 99.05 pg/mL. Spearman correlation test of total cholesterol, (HDL), triglycerides and (LDL) with IL-12 are r= 0.228 (p=0.225); r= -0.234 (p=0.212); r= 0.415 (p=0.031); r= 0,215 (p=0.291) and analysis linear regression showed a moderate correlation between the levels triglycerides and Il-12 with r=0,512 and p<0,05. There is a moderate positive correlation between triglycerides, weak between total cholesterol and LDL with IL-12 and negative correlation between HDL with IL-12 in T2DM.
PLATELET INDICES FOR PREDICTING LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS B INFECTION
Authors: Soeliauwan Shendy Sherly , Muhadi Darwati , Mutmainnah Mutmainnah
Published: April 2019

Chronic Hepatitis B involves liver parenchymal destruction leading to fibrosis. Decreased serum thrombopoietin associated with liver cell failure is thought as the leading cause of thrombocytopenia. Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) describe platelet size and degree of variation in platelet size respectively. The researchers intended to investigate whether platelet count, MPV, and PDW were variables to determine the severity of liver fibrosis in chronic hepatitis B patients. An observational study was carried out at the Dr. Wahidin Sudirohusodo Hospital Makassar from January 2015 until December 2016. A total of 100 chronic hepatitis B patients with negative HBeAg who underwent Fibroscan and complete blood count test were included in this study. A total of 100 chronic hepatitis B patients comprising, 11 with severe liver fibrosis, 16 with moderate liver fibrosis, 46 with mild liver fibrosis, and 27 with normal liver. There were significant differences in platelet count and MPV among liver fibrosis groups with p-value <0.001 and 0.046 respectively. No significant difference was observed for PDW among liver fibrosis groups (p=0.131). This study showed that platelet count and MPV were significantly different among the normal group, mild liver fibrosis group, moderate liver fibrosis group and severe liver fibrosis group in chronic hepatitis B patients. The researchers recommend to carry out studies with larger samples in number and distributed more evenly.
SPONTANEOUS PLATELET AGGREGATION IN THIRD TRIMESTER PREGNANCY AT ADAM MALIK HOSPITAL, MEDAN
Authors: Jusuf Rezqi Maulani , Pasaribu Hotma Partogi , Hariman Herman
Published: April 2019

Spontaneous Platelet Aggregation (SPA) is a condition when spontaneously platelet aggregate in plasma left in a tube at room temperature for 2-3 hours without adding any agonists. It is not entirely sure why this phenomenon happens. Pregnant females have a more tendency of hypercoagulability. Nevertheless, SPA demonstrates hyper aggregation of platelet and not the coagulation pathway. So far, there is no report regarding this phenomenon in pregnant females. This study aimed to find out whether pregnant females, especially in the third-trimester of the pregnancy, had the tendency of SPA. This cross-sectional study was established in the Department of Clinical Pathology and Department of Obstetrics-Gynecology, Adam Malik General Hospital in Medan between January–March 2016. Twenty-six females were included. Ultrasonography (USG) was used to know the age of pregnancy. From 26 females in this study, 10 were pregnant females in the third-trimester of pregnancy while 16 others were normal non-pregnant females as controls, with a mean age of 29.2±2.78 years old and 36.5±4.63 years old. There were significant differences between platelet aggregation using ADP agonist in pregnant females and controls (p <0.01). In the median Tmax 10%, there were no significant differences between platelet aggregation without ADP agonist in pregnant females and controls after 3 hours (p >0.05). Hyper aggregation and hypercoagulability in the third-trimester pregnancy tend to develop SPA. Even though there are only mild signs and symptoms, it can be an arising risk of thrombus.
CORRELATION BETWEEN PRESEPSIN AND SEQUENTIAL [SEPSIS-RELATED] ORGAN FAILURE ASSESSMENT (SOFA) SCORE AS AN ORGAN DYSFUNCTION MARKER IN SEPSIS
Authors: Dwiyani Stevi , Indrati Agnes Rengga , Lismayanti Leni , S Adhi Kristianto
Published: April 2019

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The latest consensus in 2016 (Sepsis-3) identified organ dysfunction as an acute change in total SOFA score â‰¥2 points. An ideal laboratory examination is expected to detect sepsis in an early stage and correlated with the degree of infection. Presepsin or Soluble Cluster of Differentiation 14 Sub Type (sCD14-ST) is a proteolysis product of CD14 that is produced in 1-2 hour after innate immune activation during infections. The aim of this study was to determine the correlation of presepsin and SOFA score as an organ dysfunction marker in sepsis. This research was an observational, analytical cross-sectional study conducted in the Dr. Hasan Sadikin Hospital (RSHS) Bandung from September 2016 until July 2017. The subjects were 42 patients from the Emergency Department diagnosed as sepsis by clinicians using criteria of SOFA score â‰¥2 points. The serum sample was collected and measured for presepsin concentration. A correlation test was analyzed with Spearman analysis. This study showed the increasing of presepsin concentration associated with SOFA score (p=0.000; r=0.660). There was a positive correlation between presepsin and SOFA score as an organ dysfunction marker
CORRELATION OF ATHEROGENIC INDEX OF PLASMA WITH STENOSIS LEVEL OF CORONARY ARTERY IN ACUTE CORONARY SYNDROME
Authors: Ilhamifithri Ilhamifithri , Yaswir Rismawati , Alia Eugeny , Efrida Efrida
Published: April 2019

Atherogenic dyslipidemia is the main risk factor of Acute Coronary Syndrome (ACS), caused atherosclerosis plaque and stenosis of artery coronary. Lipid profile ratio used as a marker of cardiovascular disease severity. Atherogenic Index of Plasma (AIP) calculated as logarithm triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) is a reflection of plasma atherogenicity degree and indicator of small dense low-density lipoprotein (LDL). Small dense LDL is the best predictor for cardiovascular disease, but expensive and difficult to examined. The aim of this study to determine the correlation of AIP with stenosis level of the coronary artery in ACS.  This research was an analytical study with cross-sectional design in 24 ACS patients meet the inclusion and exclusion criteria and conduct blood tests at the Central Laboratory Installation of Dr. M. Djamil Hospital Padang in January 2017- September 2017. Triglycerides and HDL-C performed by an enzymatic colorimetric method and stenosis level determined by coronary angiography. Spearman correlation was used to analyze correlation of atherogenic plasma index with stenosis level of the coronary artery, significant if p<0.05.  The subjects of this study were 20 males (83.3%) and 4 females (16.6%) with mean age 57.6(7.9) years. The mean level of HDL cholesterol and triglycerides in ACS were 34.8 (8.7) mg/dL and 155.8 (51.8)  mg/dL. The mean level of  AIP in ACS was 0.28 (0.18). Median of stenosis level of coronary artery was 80% with range 50% - 95%. Spearman correlation test showed a moderate positive correlation between AIP with stenosis level of the coronary artery in ACS (r= 0.426 ; p<0.05).  There is a moderate positive correlation between AIP with stenosis level of the coronary artery in ACS.
THE COMPATIBILITY OF NEUTROPHIL TO LYMPHOCYTE COUNT RATIO WITH SERUM PROCALCITONIN AS BACTERIAL INFECTION MARKERS IN SEPSIS PATIENTS
Authors: Elvinawaty Elvinawaty , Maani Hanifah , Rofinda Zelly Dia , Husni Husni
Published: April 2019

Bacterial infections and sepsis remain significant causes of morbidity and mortality in critical cases in Intensive Care Units (ICU) around the world. A quick and accurate diagnosis for sepsis is a challenge for clinicians and laboratory. The problem of an existing marker for sepsis with high sensitivity and specificity is still not satisfactory. Serum procalcitonin test is still widely used but cannot be supported by hospital laboratories especially in the regional public hospitals and needs more cost. Neutrophil-lymphocyte ratio is a potential index, easy, fast and cheap for bacteremia in patients with sepsis. This study aimed to determine the agreement of neutrophil-lymphocyte ratio with serum procalcitonin as a bacterial infection marker in sepsis patients. This study was an observational, analytical study with a cross-sectional design of 30 patients who had been diagnosed as sepsis by clinicians based on clinical signs of sepsis in the Intensive Care Unit of the Dr. M. Djamil Hospital Padang. The study was conducted from February to July 2016. Neutrophil and lymphocyte count was performed by flow cytometry method and procalcitonin test with Enzyme Linked Fluorescent Assay (ELFA). Results were analyzed by Kappa test with a statistical significance if p < 0.05. There were 30 subjects, consisting of 15 females (50%) and 15 males (50%) with the age mean of 48 years. Based on the Kappa test, the value obtained was kappa=0.634 (p=0.001) for the ratio neutrophil lymphocyte with procalcitonin. There was a substantial agreement between ratio neutrophil lymphocyte with procalcitonin test.
COMPARISONS OF FIBRO Q INDEX AND FIB-4 IN VARIOUS STAGES OF CHRONIC B HEPATITIS
Authors: Adrianti Evy , Kurniawan Liong Boy , Samad Ibrahim Abdul
Published: April 2019

Fibro Q and FIB-4 index are non-invasive biomarkers to evaluate liver fibrosis in chronic hepatitis. This study aimed to evaluate and compare the diagnostic accuracies of Fibro Q and FIB-4 index compared with fibroscan in chronic B hepatitis. This research was a cross-sectional study including 145 patients with chronic B hepatitis who had a fibroscan examination at the Dr.Wahidin Sudirohusodo Hospital during July 2014-June 2016. The clinical data included sex, age, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), platelet, Prothrombin Time (PT)/International Normalized Ratio (INR). Fibro Q and FIB-4 index were compared with fibroscan to predict various fibrotic degrees of chronic B hepatitis patients. There were significant differences compared to fibroscan, the highest Fibro Q average was found in the medium degree of fibrosis and the lowest in the normal fibroscan (p<0.01) while the highest FIB-4 average was found in the high degree of fibrosis and the lowest in the normal fibroscan (p<0.001). Fibro Q sensitivity and specificity test against fibroscan have AUC value of 0.579 by using a 9.33 cut-off with a sensitivity of 80.5% and specificity of 28.1%, while FIB-4 has AUC value of 0.723  by using cut-off 14.31 with sensitivity 80.5% and specificity 46.9%. These results show that both Fibro Q and FIB-4 index can be used to assess liver cirrhosis as well as fibroscan. FIB-4 Index has a better diagnostic value compared to Fibro Q, so this marker can be used as a simple screening instrument.
MICROORGANISM PATTERN ON NASAL CAVITY OF END STAGE RENAL DISEASE PATIENTS WITH REGULAR HEMODIALYSIS AND STAFFS IN HEMODIALYSIS INSTALLATION ADAM MALIK GENERAL HOSPITAL MEDAN
Authors: Damayanti Imelda , Loesnihari Ricke , Nasution Syafrizal
Published: April 2019

Colonization is the presence and growth of microorganism on the skin or mucous membrane of the body without any sign of infection. Commonly colonized microorganisms are normal flora within a person's body, but can also be microorganism in the hospital that colonizes within the body a few days after they enter the hospital. The longer a person is hospitalized the more likely to be colonized with the microorganism in the hospital. The objective is to determine microorganism pattern and antimicrobial sensitivity in the nasal cavity of regular hemodialysis patients and staff in Hemodialysis Installation of Adam Malik Hospital Medan. The study was analytic observational with a cross-sectional method, conducted in the Department of Clinical Pathology of Adam Malik Hospital Medan together with Hemodialysis Installation of Adam Malik Hospital Medan from August 2016 - October 2016. The sample was anterior nasal cavity swab which went through identification and sensitivity test. A total number of participants following the study were 46 people where patients and staffs were equal to 23 people. Most bacterial colonization of the nasal cavity of patients and staffs: Staphylococcus epidermidis 9 (39.13%) and 12 (52.17%); Staphylococcus aureus 4 (17.39%) and 3 (13.04%); Staphylococcus saprophyticus 2 (8.70%) and 2 (8.70%). There were 3 MRSA from a total of 23 bacteria (13.04%) in regular hemodialysis patients. MRSA colonization was found in regular hemodialysis patients with 50% sensitivity level of Vancomycin.
THE CORRELATION BETWEEN THE MEAN PLATELET VOLUME VALUES WITH THROMBOCYTE AGGREGATION IN NEPHROPATHY DIABETIC PATIENTS
Authors: Sunardi Agus , Dalimoenthe Nadjwa Zamalek , Rita Coriejati , Sugianli Adhi Kristianto
Published: April 2019

Diabetic nephropathy is the most important cause of end-stage renal failure. Chronic hyperglycemia will cause glomerular endothelial damage, and this damage will stimulate hemostasis activation including platelets so that platelet aggregation will increase. The increase of platelet aggregation will increase platelet consumption, which further stimulates thrombopoiesis which will lead to immature platelets of large size to be released into the circulation. This research aimed to determine the positive correlation between MPV with platelet aggregation in patients with diabetic nephropathy. This study was an analytic observational study with a cross-sectional study design. The research was conducted in the Dr. Hasan Sadikin Hospital Bandung from July 2016 to October 2017. A total of 52 subjects who met the inclusion criteria were included in the study. Mean platelet volume and platelet aggregation were performed with venous examination with EDTA and sodium citrate 3.2% anticoagulants. The result of platelet aggregation examination showing platelet hyper-aggregation was found in 44.2% of subjects, 50% normal-aggregation, 5.8% hypo-aggregation. While the median value of MPV in this study was 9.2 fL with the range of 8.00 – 11.80 fL. A positive correlation was found  between MPV value with platelet aggregation with r= 0.067, p= 0.634. The conclusion was that there was no correlation between MPV values with platelet aggregation in diabetic nephropathy patients. This small and insignificant r-value might be due to several factors that also affect platelet aggregation in diabetic nephropathy patients, requiring further investigation.
THE ROLE OF PLATELET CONCENTRATION TRANSFUSION ON THE CORRELATION BETWEEN PLATELET NUMBER AND MAXIMUM AMPLITUDE WITH BLEEDING VOLUME POST CARDIOPULMONARY BYPASS
Authors: Ristandi Ryan Bayusantika , Suraya Nida , Lismayanti Leni , Rachmayati Sylvia
Published: April 2019

Postoperative heart patients with Cardiopulmonary Bypass (CPB) are at risk of excessive bleeding. Excessive bleeding is mainly due to thrombocytopenia and platelet dysfunction. The volume of post-CPB bleeding without the administration of platelet concentrate correlates well with platelet count and Maximum Amplitude (MA). The administration of platelet concentrate in thrombocytopenia and platelet dysfunction post CPB may affect the correlation of platelet count and MA which affects the volume of bleeding. The purpose of this research was to know the role of transfusion of platelet concentration post-CPB on the correlation between platelet number and MA with the volume of bleeding. The analytical observational analytic test with the cross-sectional design was conducted on secondary data from September 2015 to March 2016. A total of 44 postoperative heart patients CPB monitored up to four hours in the room Cardiac Intensive Care Unit (CICU) Dr. HasanxSadikin HospitalxBandung. The platelet count was negatively correlated with bleeding volume (r = -0.157, p = 0.308) and the MA was negatively correlated (very weak) with bleeding volume (r = -0.171, p = 0.266). The post-CPB platelet concentrate concentration led to better patient hemostasis, as evidenced by the majority of platelet counts (97.7%)> 100,000/mm3 and MA (84%)xâ‰¥x50xmm. The post-CPB platelet concentrate causes a negative (very weak) correlation between platelet count and MA with bleeding volume
CORRELATION OF SERUM HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND HOMOCYSTEINE LEVEL IN PATIENT WITH ACUTE MYOCARDIAL INFARCTION
Authors: Putri Yayie Dwina , Prihandani Tuty , Lillah Lillah , Yaswir Rismawati
Published: April 2019

Acute Myocardial Infarction (AMI), one of the primary manifestation of coronary heart disease, is a significat cause of death worldwide. Hyperhomocysteinemia, a risk factor for cardiovascular disease, is caused by nutritional or genetic disturbances in homocysteine metabolism. The role of hyperhomocysteinemia in altered lipid metabolism presumed holds the key to an increased risk of cardiovascular disease. Hyperhomocysteinemia causes the reduction of serum High-Density Lipoprotein (HDL) cholesterol level by inhibiting hepatic synthesis of apo-A1 (significant apolipoprotein HDL). The aim of this study was to know the correlation between hyperhomocysteinemia and decreased HDL cholesterol levels for the management of cardiovascular disease risk factors. This research was an analytical study with cross-sectional design in 40 patients AMI who meet the inclusion and exclusion criteria and conduct blood test at the Central Laboratory of Hospital Dr. M. Djamil Padang and Biomedical Laboratory Faculty of Medicine Andalas University. The study was conducted in May 2016-Agustus 2017. Homocysteine level was measured by ELISA method. High-Density Lipoprotein level was performed by enzymatic colorimetric method. Data were analyzed by Spearman's correlation test. Research subjects were 40 people with male gender 30 (75%) and female 10 (25%), mean age 61.08 (11.09) year. The mean level of HDL cholesterol in patients with AMI is 41.93 ± 13.12 mg/dL. The mean level of homocysteine in patients with AMI is 25.36 ± 22.2 µmol/L. Spearman's correlation test showed a strong correlation between the levels of homocysteine and HDL cholesterol with r=-0.603 and p<0.01.
ROLE OF DELTA CHECK IN CLINICAL LABORATORY SERVICES
Authors: Sianipar Osman
Published: April 2019

Delta check is a process during post-analytical phases to detect discrepancies of test results before reporting by comparing current patient values to the previous test result. It is one of the efforts in assuring the quality of laboratory test results.  It has to be done although control of sampling, control of method, control of the instrument, control of reagents as well as control of data distribution has been done well. The difference between those two test results is compared to a delta check limit that is specific for the test parameter within a predefined time interval.  A time interval is flexible, and usually, most hospital laboratories choose 24 or 48 hours. Delta check limits should be defined so that both acceptable and unacceptable changes could be detected. Delta check limits should be based upon the total expected variation on both biological, and analytical variation. Delta check limits can be expressed as the absolute or percent difference between two consecutive results. The delta check system is addressed to evaluate changes in patient condition as well as quality sample issues and patient misidentification.
LEUKEMIC PHASE OF MALIGNANT LYMPHOMA IN CHILDREN
Authors: S Sahriany , Abdulah Agus Alim , Arif Mansyur
Published: April 2019

Leukemic phase of malignant lymphoma is a group of lymphoid malignancies typically localized in lymph node and present typical clinical features such as lymphadenopathy with irregular distribution. It can manifest as an extranodal disorder infiltrates the bloodstream (leukemic phase). Lymphomas are differentiated into Hodgkin and non-Hodgkin. The presentation of Reed-Sternberg (RS) cells in histological evaluation establishes Hodgkin lymphoma. A number of classification systems have been used before the publication of Revised European American Lymphoma (REAL) classification in 1994 which includes all lymphoid and lymphoma malignancies according to typical histology, morphology, immunophenotype, genetic, and clinical manifestation. A highly proliferative and fatal malignant lymphoma with leukemic phase case in 13 years and a one-month-old male was reported. The diagnosis was established based on marble-sized lymph nodes enlargement that increased in size, two weeks after initial identification on the neck, head, and inguinal regions and followed by lymphadenopathies in submental, right submandibular, preauricular and right inguinal region. No fever history of this patient or malignant history among his family was found. Laboratory findings included WBC of 26,050/µL, Hb 9.6 g/dL, and PLT 16,000/µL. Peripheral blood smear results indicated suspected leukemic phase of malignant lymphoma DD/ALL. Bone marrow aspiration showed leukemic-phase of malignant lymphoma with bone marrow infiltration. Cytological evaluation of Fine Needle Aspiration (FNA) identified atypical round nucleated cells with nucleus size mostly larger than the mature lymphocytes, minimum cytoplasm, diffuse erythrocyte as background, a conclusion was malignant lymphoma.
Hypogastric artery coverage during endovascular aneurysm repair in octogenarian and younger patients
Authors: Mazzaccaro Daniela , Miri Rim , Derbel Bilel , Modafferi Alfredo , Nano Giovanni
Published: April 2019

Aim

To report our experience about hypogastric artery coverage during endovascular aneurysm repair (EVAR) for aortoiliac aneurysms in patients younger than 80 years (group A) compared with octogenarian patients (group B).

Methods

Data of consecutive EVAR with hypogastric artery coverage from 01/1998 to 12/2016 were retrospectively analyzed. Primary outcomes were the occurrence of ischemic colitis, type II endoleak and buttock claudication both at 30 days and in the long term. P values less than 0.05 were considered statistically significant.

Results

The hypogastric artery was covered in 107 patients. Twenty-three (21.5%) were octogenarian (group B). At 30 days, one type II endoleak occurred in group B, whereas 16 patients of group A experienced buttock claudication. There were no cases of ischemic colitis. During follow-up (median 63.5 months), no cases of ischemic colitis occurred. Six new type II endoleaks were recorded (five in group B and one in group A, P = 0.0001). Buttock claudication persisted in four patients of group A. No new cases of buttock claudication were observed.

Conclusion

Unilateral hypogastric artery coverage during EVAR for aortoiliac aneurysms can be performed with an acceptable rate of postoperative complication. Postoperative buttock claudication was more frequent in younger patients, whereas a type II endoleak occurred mostly in octogenarian patients during follow-up.
Finite element analysis to assess the biomechanical behavior of a finger model gripping handles with different diameters
Authors: Tony Benedict Jain A.R. , Alphin Masilamany S.
Published: April 2019

Study aim: Interactions between the fingers and a handle can be analyzed using a finite element finger model. Hence, the biomechanical response of a hybrid human finger model during contact with varying diameter cylindrical handles was investigated numerically in the present study using ABAQUS/CAE.

Materials and methods: The finite element index finger model consists of three segments: the proximal, middle, and distal phalanges. The finger model comprises skin, bone, subcutaneous tissue and nail. The skin and subcutaneous tissues were assumed to be non-linearly elastic and linearly visco-elastic. The FE model was applied to predict the contact interaction between the fingers and a handle with 10 N, 20 N, 40 N and 50 N grip forces for four different diameter handles (30 mm, 40 mm, 44mm and 50 mm). The model predictions projected the biomechanical response of the finger during the static gripping analysis with 200 incremental steps.

Results: The simulation results showed that the increase in contact area reduced the maximal compressive stress/strain and also the contact pressure on finger skin. It was hypothesized in this study that the diameter of the handle influences the stress/strain and contact pressure within the soft tissue during the contact interactions.

Conclusions: The present study may be useful to study the behavior of the finger model under the static gripping of hand-held power tools.
Impact of Social Context on the Self-Concept of Gay and Lesbian Youth: A Systematic Review
Authors: Hossain Fatima , Ferreira Nuno
Published: April 2019

Objectives

Self-concept distortion has been extensively linked with decreasing mental health in gay and lesbian youth. Social context has been proposed to have a moderating effect on the development of a healthy self-concept. However, no good quality review has approached these concepts with regards to LGBT youth.

Methods

A systematic review was conducted on the relationship between social context and self-concept in gay and lesbian youth. Twenty studies were included in the review.

Results

Quality assessment of papers yielded moderate methodological strength. Findings implied that social context has considerable influence on self-concept development. Discrepancies in assessment methods, areas of social context examined, and one-dimensional nature of examining self-concept interferes with drawing explicit conclusions regarding the relationship between social context and self-concept.

Conclusion

Positivity of social context is not conclusively relatable to positive self-concept development, and similarly, a negative context is not predetermining of self-concept distortions. Building on resilience factors of gay and lesbian youth, working together with families, and advancing and utilizing available educational and community resources should mitigate the strength of overt and covert heterosexism hindering healthy self-concept development. Further longitudinal and cross-cultural research will be necessary to provide insight into the mechanisms of associations.
LncRNA: An all-rounder in rheumatoid arthritis
Authors: Liang Junyu , Chen Weiqian , Lin Jin
Published: April 2019

Rheumatoid arthritis (RA) is a chronic autoimmune disease and is supposed to have both genetic and environmental backgrounds. Plenty of studies have demonstrated the roles of long non-coding RNAs (lncRNAs) in the initiation and development of RA. Numerous lncRNAs have been found to be dysregulated in RA and to be correlated with disease activity of RA, which indicates potential diagnostic roles of lncRNAs. In addition to working as biomarkers for RA, lncRNAs participate in many specific pathological processes including inflammation, aberrant proliferation, migration, invasion and apoptosis. Further screenings and researches are required to validate the clinical potentials of lncRNAs as diagnostic and therapeutic targets in RA.
Clinical conundrums in the management of diabetic ketoacidosis in the elderly
Authors: Sehgal Vishal , Ulmer Brian
Published: April 2019

One of the dreaded life-threatening complications of diabetes mellitus (DM) is diabetic ketoacidosis (DKA). American Diabetic Association (ADA) came out with 2018 guidelines on the management of DM and its complications, but these are woefully silent on the clinical conundrums that accompany DKA in elderly patients. In elderly patients, DKA is often complicated by sepsis, atrial fibrillation, polypharmacy, nonketotic hyperosmolar states, atypical clinical presentations, acute kidney injury (AKI), dementia, and noncompliance with medications. Here in we highlight these conundrums that need to be addressed to improve morbidity and mortality in elderly patients.
Importance of studying the levels of hepcidin and vitamin D in Egyptian children with chronic hepatitis C
Authors: Mohamed Amal Ahmed , Abd Almonaem Eman R. , Mansour Amira I. , Algebaly HebatAllah Fadel , Khattab Rania Abdelmonem , El Abd Yasmine S.
Published: April 2019

Background and Objective

Hepcidin is the key regulator of iron metabolism and is a significant biomarker for systemic inflammatory states. Vitamin D is a powerful immunomodulator and plays a significant role in the inflammatory responses and fibrosis occurring due to hepatitis C virus (HCV) infection. This study assessed the level of vitamin D and serum hepcidin and its expression in peripheral blood of children with chronic hepatitis C (CHC) and correlated them with other serum markers to reflect iron metabolism and liver disease severity.

Methods

A total of 100 children were included in this study: 50 with HCV infection and 50 healthy controls. Biochemical parameters together with vitamin D, hepcidin, and its expression were all measured.

Results

The level of hepcidin and its expression together with vitamin D and hepcidin-to-ferritin (H/F) ratios were significantly reduced in patients, but the iron and ferritin levels were higher (P<0.001). Serum hepcidin level showed significant positive correlation with hepcidin expression, HCV titer, iron, ferritin, and H/F ratio (r = 0.43, 0.31, 0.34, 0.28, and 0.91, respectively) but significant negative correlation with vitamin D (r = −0.37). Both hepcidin and ferritin were higher in patients with Child Pugh scores B and C than those with score A (P<0.001).

Conclusion

Measuring serum hepcidin and its expression together with vitamin D levels in patients may have a prognostic value and is promising in the follow-up of the severity of liver disease.
Management of patients with liver cirrhosis and invasive bladder cancer: A case-series
Authors: Zachos Ioannis , Zachou Kalliopi , Dalekos George N. , Tzortzis Vasileios
Published: April 2019

Liver cirrhosis is a major risk factor for increased mortality and morbidity in patients undergoing non-hepatic surgery with overall mortality rates as high as 45–50%. However, cirrhotic patients are often in need of surgical procedures including urological surgeries like cystectomies for muscle invasive bladder cancer. Data on the prognosis of these patients undergoing cystectomy for bladder cancer are scarce in the literature. In the present case-study, we describe the outcomes of 3 patients with liver cirrhosis who underwent radical cystectomy for muscle invasive bladder cancer. To the best of our knowledge, this is the first study reporting on this kind of urological surgery in patients with liver cirrhosis. Accordingly, we provide a review in the literature on prognosis and factors influencing the survival of cirrhotic patients who undergo surgical procedures.
Favorable outcome in a patient with systemic BCGitis after intra-bladder instillation of Calmette-Guerin Bacillus highlighting the importance of making the correct diagnosis in this rare form of sepsis
Authors: Attou Rachid , Albrich Thomas , Kadou Joe , Redant Sebastien , Honoré Patrick M. , Bels David De
Published: April 2019

We present the case of a patient with sepsis following a traumatic intra-bladder instillation of Calmette-Guerin Bacillus with pneumonia and possibly hepatitis. These complications are rare and could be induced by both immuno-allergic reaction and bacteremia. There is no specific guideline to treat this condition, but many clinicians depicting similar cases seem to agree on prolonged anti-tuberculous antibiotics with associated corticosteroid therapy. Following this therapy, the prognosis is generally favorable depending upon the fact that diagnosis has correctly been made. Our case highlights the fact that correct diagnosis has to be made especially in the presence of sepsis without a clear septic source.
Vom Siedlungsbrei zum Städtischen? Eine mehrdimensionale Bestandsaufnahme der Suburbanisierung
Authors: Adam Brigitte
Published: April 2019

In view of a phase of reurbanisation of German large cities, in this paper the question is raised, whether, where, with which intensity and tendency suburbanisation still can be found. Answers will be delivered by a multidimensional quantitative model. In addition to the population development, which often indicates a reurbanisation or suburbanisation trend, it includes the labour market and land consumption. Going beyond city-hinterland relations, it is investigated whether the surrounding areas of large cities show a development according to the ideal of decentralised concentration – in particular a concentration on medium-sized cities – or whether the development is more dispersely spread over smaller towns and municipalities. The calculations lead to a suburbanisation index, which can be periodically produced every few years (monitoring). Beyond a perspective mainly orientated towards the population development, the suburbanisation idea is improved and completed. Comparing the various dimensions (population, labour market, land consumption) generates partly controversial results.
Conceptualising Quality in Spatial Planning
Authors: Stöglehner Gernot
Published: April 2019

Quality discourses help to legitimate professions. This article therefore addresses the crucial question of how quality can be framed in spatial planning. Based on the context of spatial planning in Austria, this article introduces a normative framework for quality in spatial planning that considers the four dimensions of content, planning methodology, planning process and legal compliance, and shows howthese four dimensions are interlinked. Furthermore, it discusses how quality can be enhanced by concerted governmental action and further education for planners. It is argued that planners might need to adopt a new role as 'teachers' in planning processes to facilitate societal learning processes in order to raise the quality of planning. Finally, it is concluded that the quality debate in spatial planning can be useful to calibrate expectations of planners and society to directly influence sustainable spatial development through spatial planning, to communicate achievements in planning, to raise awareness for sustainable spatial development, and to improve legal frameworks, planning methodology, and planners' training and further education.
Das Portfolio deutscher Biosphärenreservate im Lichte der Sustainable Development Goals
Authors: Job Hubert , Engelbauer Manuel , Engels Barbara
Published: April 2019

This paper discusses the representativeness of the German Biosphere Reserves. The United Nations Sustainable Development Goals will serve as the theoretical framework of this analysis. Germany currently accounts a share of 16 % of the terrestrial land area under strict nature protection. This means that there is no quantity problem. Rather, the question arises about the number, geographical distribution and quality of protected areas – in this example Biosphere Reserves. So far, scientific papers only focus on the natural landscape representativeness of Biosphere Reserves in Germany. This is not enough for this category of protected areas as it rests on the paradigm of sustainable development. This is why this paper is focusing on possible structural and socioeconomic shortcomings in the network of German Biosphere Reserves. Therefore, precise indicators will be analysed in form of thematical maps to address selected Sustainable Development Goals. Furthermore, the existing Biosphere Reserves will be analysed if and to what extent they are able to reach their intended exemplary function towards "the rest of the world" as models for sustainable development.
Strength and Deformation of Sand-Tire Rubber Mixtures (STRM): An Experimental Study
Authors: Al-Rkaby Alaa H. J.
Published: April 2019

Waste material such as used tires is increasing every year, which poses environmental problems. However, such material has been used in several geotechnical applications as alternative lightweight backfill in highway embankments and/or behind retaining walls, providing environmental, economic and technical benefits. These applications require knowledge of engineering properties of soil-tire rubber mixtures. The present study aims to show the possibility of tire rubber usage in sand by evaluating the shear strength and deformability of sand mixed with granulated rubber, in weight percentages between 0 and 50%. The tire rubber content was found to influence the stress-strain and deformation behavior of the mixtures. The shear strength of sand mixed with 10% or 20% tire rubber was higher than that measured for sand only. However, the trend for TRC = 30–50% was different. Samples with a rubber content of 30-50% exhibited a rapid decrease in the stress ratio compared with that of sand. The major principal strain at maximum stress ratio was found to increase with increasing tire rubber content. However, it was observed that the lateral strains (minor and intermediate principal strains) of samples reduced significantly with the addition of tire rubber to the sand.
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Authors: Admin Admin
Published: April 2019

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The role of Prosecution in the Trial
Authors: Abdellatif Baraa Munther Kamal , Al-Ani Mohammed Hasan Jassim
Published: April 2019

The prosecution plays an important role at the trial stage through the presence of its representation of the proceedings of the trial, the submission of applications, the discussion of witnesses and experts and the questioning of the accused. The court does not sit without his presence. The prosecutor does not invite the trial sessions to invalidate the judgments and decisions issued at those hearings. The law grants the public prosecutor the power to challenge them in order to ensure the control of criminal legality and the extent to which it conforms to the provisions of the law by discriminating and correcting the discriminatory decision and retrial.
Bridging the gap: Spinal cord fusion as a treatment of chronic spinal cord injury
Authors: Ren Xiaoping , Kim C-Yoon , Canavero Sergio
Published: April 2019

Despite decades of animal experimentation, human translation with cell grafts, conduits, and other strategies has failed to cure patients with chronic spinal cord injury (SCI). Recent data show that motor deficits due to spinal cord transection in animal models can be reversed by local application of fusogens, such as Polyethylene glycol (PEG). Results proved superior at short term over all other treatments deployed in animal studies, opening the way to human trials. In particular, removal of the injured spinal cord segment followed by PEG fusion of the two ends along with vertebral osteotomy to shorten the spine holds the promise for a cure in many cases.