Community Behavior Patterns That Influence The Causes of Dengue Hemorrhagic Fever (DHF) in The Pondok Petir Elementary Region

Dengue Hemorrhagic Fever (DHF) is a disease caused by the bite of the Aedes Aegypti mosquito infected with one of the four types of dengue virus with clinical manifestations of fever, muscle aches, and/or joint pain accompanied by leukopenia, rash, lymphadenopathy, thrombocytopenia and hemorrhagic diathesis. In dengue hemorrhagic fever, plasma leakage occurs which is characterized by hemoconcentration (increased hematocrit) or fluid accumulation in body cavities (World Health Organization). Dengue Hemorrhagic Fever Penyakit (DHF) is still one of the main public health problems in Indonesia. The number of sufferers and the area of ​​spread of DHF is increasing along with the increase in mobility and population density, especially in tropical and sub-tropical areas (Kemenkes RI, 2010). At the beginning of 2019, Dengue Hemorrhagic Fever (DHF) again increased in several areas, even becoming an Extraordinary Event (KLB) status. In January 2019 there were 15,132 DHF sufferers with 145 people dying in 34 provinces. This figure is twice as high as the figure at the end of January 2018 which recorded 6,167 DHF sufferers with 43 people dying. To find out the behavioral factors of DHF disease in the community in the Pondok Petir sub-district area in 2020. Research Setting: According to data in 2019, Dengue Hemorrhagic Fever (DHF) has increased again in several areas, even becoming an Extraordinary Event (KLB) status. In January 2019 there were 15,132 DHF sufferers with 145 people dying in 34 provinces. This figure is twice as high as the figure at the end of January 2018 which recorded 6,167 DHF sufferers with 43 people dying. East Java, West Java, and DKI Jakarta are the three provinces that experienced an increase in the number of dengue cases compared to the previous year. This research uses the Simple Random Sampling technique. This study studied the incidence of dengue in children to adults (dependent variable), with respondent characteristics (age, history of dengue disease), counseling (knowledge), attitudes (family attitudes), and behavioral patterns (behavior of health workers, rarely monitoring larvae). mosquitoes, distribution of abate powder, fogging activities), and increasing community participation in dengue prevention (independent variable). To obtain the data, an in-depth interview and document review approach was conducted with the community at Pondok Petir. This research was conducted at Pondok Petir, South Tangerang in June 2021. The sub-categories in this study were DHF, Age, History of DHF, Knowledge, Family Attitude, Behavioral Patterns, Behavioral Patterns of Health Workers, Rarely Monitoring Mosquito Larvae, Distribution of Abate Powder, Fogging Activities, Facilities, Facilities, Increased Participation Society in Dengue Prevention. It takes a lot of education to the people of Pondok Petir to make people aware of the importance of knowing about DHF. The most effective and efficient prevention of dengue fever to date is the Mosquito Nest Eradication (PSN) activity using 3M Plus, namely: 1) Draining, is cleaning places that are often used as water reservoirs such as bathtubs, water buckets, water reservoirs drinking water, water reservoirs, refrigerators, etc. 2) Closing, namely closing water reservoirs such as drums, jugs, water towers, and so on; and 3) Reusing or recycling used goods that have the potential to become breeding grounds for dengue-transmitting mosquitoes.

Large cavernous carotid artery aneurysm with spontaneous thrombosis: is there more to a change in morphology than there seems to be? Illustrative case

BACKGROUND The pathogenesis and endovascular treatment strategy for spontaneously thrombosed unruptured cerebral aneurysms have not yet been comprehensively described. OBSERVATIONS The authors reported on a 78-year-old woman who had large bilateral unruptured cavernous carotid artery aneurysms that induced chronic disseminated intravascular coagulation and acquired factor XIII deficiency. The right aneurysm was symptomatic and partially thrombosed. Hemorrhagic diathesis and abnormal values of laboratory data improved after administration of recombinant human thrombomodulin followed by endovascular treatment in which three pipeline embolization devices were deployed for the right aneurysm. LESSONS To the best of the authors’ knowledge, this was the first report of an unruptured cerebral aneurysm leading to coagulation disorders with clinical manifestation that was treated successfully by endovascular intervention after intensive perioperative management.

The effect of rubbing the skin on the composition of the tested blood

The observed Bittorf'oM appearance in the peripheral blood of a patient with chronic endocarditis and hemorrhagic diathesis of endothelial cells due to rubbing of the blood sampling site (ear lobe) was given to Dr. P. Dvizhkov (Virch. Arch. F. Path. An., Bd. 245, 1923) thought to trace this phenomenon to patients with typhus.

Massive Right Atrial Thrombosis: Are You Brave Enough to Start Anticoagulation? A Case Report

Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic stem cell disorder with overlapping myelodysplastic and myeloproliferative features. The disease is generally characterized by blood monocytosis, bone marrow dysplasia, cytopenia, and hepatosplenomegaly. While malignant blood diseases are frequently associated with a high risk of thromboembolism, CMML is often accompanied by immune-mediated hemorrhagic diathesis. Indeed, very few reports in literature report thrombotic complications of CMML patients. We will briefly present here the case of a patient with CMML who developed a massive right atrial thrombus. We aim to highlight the non-negligible thrombotic burden of the disease, and we will get through the differential diagnosis of right atrial masses and the management of right atrial thrombi, which are a rare and poorly known entity.

EDTA‑dependent pseudothrombocytopenia in child (clinical case report)

Ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia is the phenomenon of a spurious low platelet count due to antiplatelet antibodies that cause platelet clumping in blood anticoagulated with EDTA. The aggregation of platelets in EDTA-dependent pseudothrombocytopenia is usually prevented by other anticoagulants, such as sodium citrate. EDTA-dependent pseudothrombocytopenia has never been associated with hemorrhagic diathesis or platelet dysfunction. In this article, a 2,5-year-old boy with EDTA-dependent pseudothrombocytopenia is presented because of rare presentation. We report that EDTA can induce platelet clumping, and thus spuriously low platelet counts. However, aggregation of platelets was not detected in blood samples with sodium citrate, and platelet count was normal.

A Modified in vitro Clot Lysis Assay Predicts Outcomes in Non-traumatic Intracerebral Hemorrhage Stroke Patients—The IRONHEART Study

Background: Non-traumatic intracerebral hemorrhage (ICH) accounts for 10–15% of all strokes and results in a higher rate of mortality as compared to ischemic strokes. In the IRONHEART study, we aimed to find out whether a modified in vitro clot lysis assay method, that includes the effect of neutrophil extracellular traps (NETs) might predict ICH outcomes.Patients and Methods: In this prospective, observational study, 89 consecutive non-traumatic ICH patients were enrolled. Exclusion criteria included aneurysm rupture, cancer, liver- or kidney failure or hemorrhagic diathesis. On admission, detailed clinical and laboratory investigations were performed. ICH volume was estimated based on CT performed on admission, day 14 and 90. A conventional in vitro clot lysis assay (CLA) and a modified CLA (mCLA) including cell-free-DNA and histones were performed from stored platelet-free plasma taken on admission. Clot formation and lysis in case of both assays were defined using the following variables calculated from the turbidimetric curves: maximum absorbance, time to maximum absorbance, clot lysis times (CLT) and area under the curve (CLA AUC). Long-term ICH outcomes were defined 90 days post-event by the modified Rankin Scale (mRS). All patients or relatives provided written informed consent.Results: Patients with more severe stroke (NIHSS>10) presented significantly shorter clot lysis times of the mCLA in the presence of DNA and histone as compared to patients with milder stroke [10%CLT: NIHSS 0–10: median 31.5 (IQR: 21.0–40.0) min vs. NIHSS>10: 24 (18–31.0) min, p = 0.032]. Shorter clot lysis times of the mCLA showed significant association with non-survival by day 14 and with unfavorable long-term outcomes [mRS 0–1: 36.0 (22.5.0–51.0) min; mRS 2–5: 23.5 (18.0–36.0) min and mRS 6: 22.5 (18.0–30.5) min, p = 0.027]. Estimated ICH volume showed significant negative correlation with mCLA parameters, including 10%CLT (r = −0.3050, p = 0.009). ROC analysis proved good diagnostic performance of mCLA for predicting poor long-term outcomes [AUC: 0.73 (0.57–0.89)]. In a Kaplan-Meier survival analysis, those patients who presented with an mCLA 10%CLT result of >38.5 min on admission showed significantly better survival as compared to those with shorter clot lysis results (p=0.010).Conclusion: Parameters of mCLA correlate with ICH bleeding volume and might be useful to predict ICH outcomes.

Case Report: ANXA2 Associated Life-Threatening Coagulopathy With Hyperfibrinolysis in a Patient With Non-APL Acute Myeloid Leukemia

Patients with acute promyelocytic leukemia (APL) often present with potentially life-threatening hemorrhagic diathesis. The underlying pathomechanisms of APL-associated coagulopathy are complex. However, two pathways considered to be APL-specific had been identified: 1) annexin A2 (ANXA2)-associated hyperfibrinolysis and 2) podoplanin (PDPN)-mediated platelet activation and aggregation. In contrast, since disseminated intravascular coagulation (DIC) is far less frequent in patients with non-APL acute myeloid leukemia (AML), the pathophysiology of AML-associated hemorrhagic disorders is not well understood. Furthermore, the potential threat of coagulopathy in non-APL AML patients may be underestimated. Herein, we report a patient with non-APL AML presenting with severe coagulopathy with hyperfibrinolysis. Since his clinical course resembled a prototypical APL-associated hemorrhagic disorder, we hypothesized pathophysiological similarities. Performing multiparametric flow cytometry (MFC) and immunofluorescence imaging (IF) studies, we found the patient’s bone-marrow mononuclear cells (BM-MNC) to express ANXA2 - a biomarker previously thought to be APL-specific. In addition, whole-exome sequencing (WES) on sorted BM-MNC (leukemia-associated immunophenotype (LAIP)1: ANXAlo, LAIP2: ANXAhi) demonstrated high intra-tumor heterogeneity. Since ANXA2 regulation is not well understood, further research to determine the coagulopathy-initiating events in AML and APL is indicated. Moreover, ANXA2 and PDPN MFC assessment as a tool to determine the risk of life-threatening DIC in AML and APL patients should be evaluated.

Pathomorphological Changes in Calves with Intrauterine Colibacteriosis

Cattle provide valuable food and raw materials for various types of industry, which is why the successful development of breeding of this type of farm animal plays an important role for the economy of the Russian Federation. Unfortunately, calves, due to stressful conditions and improper maintenance, feeding and exploitation of pregnant cows, are susceptible to diseases of the gastrointestinal tract. Colibacteriosis is one of the main causes of loss of productivity and mortality of young cattle. Therefore, the study of methods for the prevention, diagnosis and treatment of this disease is an urgent problem of veterinary medicine. This article examines the clinical and pathological methods of studying calves with intrauterine colibacteriosis. The results are presented in the form of photographs of pathomorphological changes in organs and tissues with a list of eleven pathological diagnoses inherent in escherichiosis, such as dehydration, exhaustion and anemia; hemorrhagic diathesis; acute serous lymphadenitis; acute serous splenitis (septic spleen); fatty degeneration and hemorrhages in the liver; acute catarrhal bronchopneumonia, mainly of the apical and cardiac lobes; hyperemia and hemorrhage under the epi- and endocardium; acute alterative myocarditis; acute catarrhal or hemorrhagic gastroenterocolitis; hemorrhagic or acute catarrhal with banded hemorrhage proctitis; and acute serous nephritis. For the study, we selected 16 calves of Holstein-Friesian and Brown Schwyz breed from the age of newborns to two weeks of age with symptoms of toxic dyspepsia. For the pathological studies, autopsiesof 10 corpses of calves from 1 to 5 days of life were performed. Keywords: intrauterine colibacteriosis, calves, pathological changes

What’s Eating You? Black Butterfly (Hylesia nigricans)

Lepidopterism refers to the adverse medical effects of contact with insects of the order Lepidoptera, which includes both moths and butterflies. These effects typically result from contact with an insect during the caterpillar (larval) stage. Lepidopterism involves multiple pathologic mechanisms, including direct toxicity of venom and mechanical irritant effects. Clinical patterns associated with contact with lepidoptera include localized stinging reactions, papular urticaria and dermatitis, urticarial wheals, and hemorrhagic diathesis. Accurate diagnosis of symptoms associated with contact with caterpillars, butterflies, or moths is nearly impossible without a reliable history of exposure, as the histology of exposure is nonspecific. Treatment is largely empiric and should be based on symptoms. We report a case of lepidopterism in a patient with acute cutaneous lesions following exposure to an adult-stage black butterfly (Hylesia nigricans).