Tuberculosis Arthritis Genu Sinistra with Drug-Induced Liver Injury, COVID 19 Confirmed

Background. Tuberculosis is still a significant health problem, especially in developing countries. Although pulmonary tuberculosis is the most common form of the disease, extrapulmonary tuberculosis also contributes significantly to morbidity and mortality. 10-15% of extrapulmonary cases are due to tuberculous arthritis. The following is a case report of a 36-year-old woman with a diagnosis of genu Sinistra tuberculosis arthritis and drug-induced hepatotoxic injury due to OAT. Case presentation. A woman, 36 years old, Muslim, addresses Banyuasin. The patient is a housewife, treated at Dr. Moh Hoesin General Hospital since October 11, 2021. The main complaint in the form of pain in the left knee has been getting worse since 1 week before being admitted to the hospital. 4 months before admission the hospital, the patient complained of left knee pain, the pain felt like being stabbed, coming and going, especially when walking. In this patient, there was a complaint of nausea that was felt in the pit of the stomach. The results of laboratory examinations showed an increase in the transaminase enzyme and hyperuricemia, so it was suspected that the patient had DILI due to OAT drugs. Hepatocyte death in DILI can occur through two processes, namely processes mediated by apoptosis or necrosis. In apoptosis, cell shrinkage and fragmentation occur into small pieces with the cell membrane intact. These fragments are cleared by phagocytosis and generally do not stimulate the host immune response. Conclusion. A patient diagnosed with arthritis tuberculosis genu Sinistra with Drug-Induced Liver Injury and Confirmed COVID 19.

Examination of Haemoglobin (HB) Levels of Young Women and Counseling on Iron Deficiency Anemia in Young Women and Administration of Fe Tablets

The problem of iron deficiency is a common problem in developing countries, Indonesia being one of them. One of the targets for increasing iron is young women because it influences growth and development to become pregnant women. The purpose of this community service activity is to check hemoglobin levels and focus on increasing young women's understanding of the situation of iron deficiency anemia during the Covid 19 Pandemic. So that after sense emerges, it is hoped that they will be able to implement awareness to consume Fe tablets. The method used is to provide health education in the form of interactive lectures and check hemoglobin levels. The target of the implementation of this activity is all 20 students of SMP Terpadu Ishlahul Mubtadiin Cihaurbeuti Ciamis grades 7, 8, and 9. The results of laboratory examinations, most of the students did not experience anemia as much as 65%, but there were 35% of students who had anemia, either mild (20%), moderate (10%), and severe (5%). The results of the examination laboratories most big girls do not experience anemia as much as 65%, but there are 35% of students experiencing anemia both mild (20%), moderate (10 %), and weight (5%). Activity devotion people have managed to achieve the purpose of its implementation, namely the increase in understanding adolescent daughter against situation anemia, with the discovery of cases of anemia in target further increase the awareness of the target, especially teenage daughter in changing patterns of life, especially eating food that is nutritious as well pattern rest of the teenagers are.

Positive experience in laser therapy of patients with polysystemic disorder syndrome with hvdmp using scanning beams through the vagina

Low-intensive laser therapy was carried out on 550 women aged 18 to 33 with syndrome of polysystemic disorders at chronic genital inflammations.Efficiency of frequency movement (301 patients) and stable regime (249 patients) of endovaginal low-intensive laser therapy has been studied by means of complex clinical, functional, instrumental, and laboratory examinations. Movement regime of laser application proved to stimulate sexual visceral reactions improving the state of female organism in case of syndrome of polysystemic disorders. Normalization of the sexualfunction as a result of movement regime in endovaginal laser therapy can be considered as pathogenic influence directed on normalizing and supporting physiological nervous-reflex connections of genital organs with other organs and systems of womens organisms.

EFFECT OF HIGH PROTEIN DIET IN ACTIVITY OF ANTIOXIDANTS AND LEVEL OF INFLAMMATION ON SPRINT ATHLETE

This study aims to analyze the effect of a low-carbohydrate high-protein diet to increase the level of antioxidant, decrease inflammation and improve performance of athlete. The research was carried out by experimental research methods, within the design of "Randomized Control Group Pretest Posttest Design".A sample was taken from 20 people who met the inclusion and exclusion criteria from 30 teenage athletes in PASI East Java sprints. The Data were collected by measuring the sprint results by finish photo camera and laboratory examinations to determine the levels of antioxidants (SOD) and the inflammation degree (TNF α)in blood. The data were analyzed using multivariate technique (Manova) Hotelling's method (T2). Hypothesis testing using α0.05. The results and conclusions of the study stated that the normal diet had no effect on the variables of sprint running speed, SOD and TNF-α levels. While low-carbohydrate and high-protein diet can increase SOD levels of 211.44 /gHb, reduce (TNF α) at least 0.309 pg/ml, and the average increase in antioxidant activity caused by low-carbohydrate-high-protein diet is 24,989 / gHb higher than normal diet, the decrease in the degree of inflammation is 0.196 pg/ml, however, it has no effect on the speed of sprint.

Effect of high protein diet in activity of antioxidants and level of inflammation on sprint athlete

This study aims to analyze the effect of a low-carbohydrate high-protein diet to increase the level of antioxidant, decrease inflammation and improve performance of athlete. The research was carried out by experimental research methods, within the design of “Randomized Control Group Pretest Posttest Design”. A sample was taken from 20 people who met the inclusion and exclusion criteria from 30 teenage athletes in PASI East Java sprints. The Data were collected by measuring the sprint results by finish photo camera and laboratory examinations to determine the levels of antioxidants (SOD) and the inflammation degree (TNF-α) in blood. The data were analyzed using multivariate technique (Manova) Hotelling’s method (T2). Hypothesis testing using α = 0.05. The results and conclusions of the study stated that the normal diet had no effect on the variables of sprint running speed, SOD and TNF-α levels. While low-carbohydrate and high-protein diet can increase SOD levels of 211.44/gHb, reduce (TNF-α) at least 0.309 pg/ml, and the average increase in antioxidant activity caused by low-carbohydrate-high-protein diet is 24.989/gHb higher than normal diet, the decrease in the degree of inflammation is 0.196 pg/ml, however, it has no effect on the speed of sprint.

Effect of Need, Easy, and Trust on the Intensity of Using the Mobile Health Application to Conduct a Laboratoty Examination

This study aims to analyze the influence of need, convenience and trust on the intensity of using the mobile health application to perform laboratory examinations on Pramita Lab Surabaya patients. This research is important because the intensity of the use of the mobile health application is influenced by the needs, convenience and trust of patients in the mobile health application. The sample in this study were all 108patients using the mobile health application at Pramita Lab Surabaya. The research design used is quantitative research with a descriptive approach with an emphasis on theory testing through measurement of research variables through distributing research questionnaires. The distribution of research questionnaires was carried out using probability sampling techniques. The analysis technique in this study is to use multiple linear regression analysis with the help of SPSS 20.0 software. The results showed that the variables of need, convenience and trust had a positive and significant effect simultaneously on the intensity of using the mobile health application in patients at Pramita Lab Surabaya. The result also show that there is a positive and significant influence on the need, convenience and trust on the intensity of using the mobile health application by patients at Pramita Lab Surabaya.

Shwachman–Diamond Syndrome

This article describes a clinical case of a rare Schwachman–Diamond syndrome. It covers the features of the clinical picture of the disease and the laboratory examinations. A multidisciplinary approach for the purpose of early diagnosis, timely initiation of complex treatment, including nutritional therapy, prescription of enzyme preparations and granulocyte colony-stimulating factor, makes it possible to improve the quality of life and prognosis in such patients.

Modifying effects of TNF-α, IL-6 and VDR genes on the development risk and the course of COVID-19. Pilot study

Objectives COVID-19 continues to range around the world and set morbidity and mortality antirecords. Determining the role of genetic factors in the development of COVID-19 may contribute to the understanding of the pathogenetic mechanisms that lead to the development of complications and fatalities in this disease. The aim of our study was to analyze the effect of TNF-α (rs1800629), IL-6 (rs1800795) and VDR (rs731236 and rs1544410) genes variants on the development risk and the course of COVID-19 in intensive care patients. Methods The study group included 31 patients with diagnosis “viral COVID-19 pneumonia”. All patients underwent standard daily repeated clinical, instrumental and laboratory examinations. Determination of IL-6, TNF-α, and VDR genes variants was performed using the PCR-RFLP method. Results It was found a significant increase in the rate of the CC genotype and C allele (38.7 vs. 12.0% and 0.6 vs. 0.4%, respectively) of the IL-6 gene in all patients of the study in comparison with population frequencies. There was a significantly higher rate of heterozygous genotypes TC and GA of the VDR gene in group of died patients. The rs1800629 variant of the TNF-α gene is associated with the need for respiratory support and its longer duration in patients with COVID-19. Conclusions The obtained results support a hypothesis about the influence of variants of IL-6, TNF-α and VDR genes on severity of COVID-19. However, in order to draw definite conclusions, further multifaceted research in this area are need.

A full-term pregnant woman with secondary Evans syndrome caused by severe coronavirus disease 2019: a case report

Background In this report, we describe a very challenging case of a patient with secondary Evans syndrome caused by severe coronavirus disease 2019 infection in a pregnant full-term woman. Case presentation A 29-year-old full-term pregnant Indonesian woman presented with gross hematuria, dry cough, fever, dyspnea, nausea, anosmia, and fatigue 5 days after confirmation of coronavirus disease 2019 infection. Laboratory examinations showed very severe thrombocytopenia, increased indirect bilirubin, and a positive direct Coombs’ test. From peripheral blood, there was an increased number of spherocytes, which indicated an autoimmune hemolytic process. Antinuclear antibody and anti-double-stranded DNA test results were negative, and her virology serological markers are also negative for human immunodeficiency virus, cytomegalovirus, and hepatitis B and C. Despite aggressive treatment with platelet transfusion, high-dose steroid, and thrombopoietin receptor agonists, the platelet count did not recover, and a speculative cesarean delivery had to be done with a very low platelet count.

659 Myocardial infarcion and ischaemic stroke in a COVID-19 patient: nothing happens by chance

A 68-years-old man, affected by arterial hypertension in treatment with angiotensin-receptor blocker (cardesartan 32 mg), was admitted to emergency department for fever and dyspnoea. The molecular swab for SARS-CoV-2 was positive. Chest CT showed bilateral interstitial pneumonia with Chung severity score index 15/20. The laboratory examinations showed: PCR 21 mg/dl, IL-6 17 pg/ml, d-dimer 374 ng/ml, lymphopenia, glycaemia 218 mg/dl, total cholesterol 245 mg/dl. At COVID-19 diagnosis he started the following therapy: Azithromycin 500 mg once a day, Methylprednisolone 20 mg twice a day, Remdesivir 200 mg once a day, Enoxaparin 6000 UI twice a day, Insulin Lispro 6/8/8 UI three times a day, High FlowNasal Cannula (FiO2 45%). No lipid-lowering therapy was prescribed. During the hospitalization, the patient experienced a progressive improvement in clinical and laboratory parameters. On the 28th day, there was a sudden worsening of dyspnoea with evidence of ST-elevation in DI, aVL, V2–V6 leads. A primary percutaneous coronary intervention at COVID-19 HUB hospital (2.9 km away) was required. Because of massive demand for emergency vehicles, the patient was admitted to the Chat Lab 3 h and 23 min later. Due to evidence of critical stenosis of the proximal and intermediate left anterior descending artery, a PTCA with stenting was performed. 12 h later, the patient developed left hemiplegia (NIHSS score: 7). The brain CT revealed an acute right frontal ischaemic lesion; no indication to fibrinolysis was given by the consultant neurologist. Our case report describes the rare concomitance of two thrombotic events in a COVID-19 patient with many cardiovascular risk factors, offering the opportunity to underline the need of their appropriate treatment during the hospitalization for SARS-CoV-2 infection. Moreover, a dedicated treatment pathways should be provided for COVID-19 patients in order to ensure the timely and correct application of the protocols suggested by the international guidelines. 659 Figure 1ECG performed at the onset of acute dyspnoea.659 Figure 2Critical stenosis on LAD and subcritical stenosis on first and second obtuse marginal arteries.