Immature Platelet Fraction in Thrombocytopenic Patients

Bone marrow puncture (BMP), is usually performed to identify thrombopoiesis activity and is still the gold standard to determine the etiology of thrombocytopenia. This diagnostic test is invasive hence it may cause discomfort to the patient. One of noninvasive test to determine the etiology of thrombocytopenia is by measuring immature platelet fraction (IPF). IPF is highly correlated to the activity of thrombopoiesis and by understanding the value, clinicians are able to use it in determining whether or not invasive examination is needed and more importantly avoiding unnecessary platelet transfusion. This research was a cross-sectional descriptive observational study aimed to evaluate IPF value in thrombocytopenic inpatients in the Department of Internal Medicine, Haji Adam Malik Hospital Medan. 83 people were recruited, 48 were female (57.83%) and 35 were male (42.16%). IPF values ranged 0,5-59,6% using Sysmex XN-1000 (reference range 1-4,8%). There were 5 (6.02%) low IPF values, 29 (34.93%) normal IPF values and 49 (59.03%) high IPF values. Evaluation of IPF in thrombocytopenic patients is a promising tool to discriminate central from peripheral thrombocytopenia.

Correlation between HbA1C and D-dimer in Type 2 Diabetic with COVID-19 Patients

Background: Coronavirus disease-19 (COVID-19) is the disease caused by 2019-nCoV/SARS-CoV-2, a novel β corona- virus of group 2B . COVID-19 has been reported to be associated with severe condition with type 2 diabetes mellitus (T2DM). D-dimer is a by product of fibrin degradation. It is widely recognized as a biomarker for thromboembolism and as a prognostic marker for critical patients. Methods: This study uses secondary data, which is obtained by looking at the contents of patient medical records at H. Adam Malik Medan Hospital between 2020-2021. The population of this study was all inpatients confirmed COVID-19 through an RT-PCR SARS-CoV-2 swab examination. The study sample was obtained by the total sampling method, where all populations that meet the criteria of inclusion and exclusion are used as research samples. Patients were triaged as per severity on basis of national guidelines: asymptomatic, Mild (respiratory rate < 24/min, SpO2 >94% at room air), moderate (respiratory rate: 24-30/min, SpO2 90-94% at room air) and severe (respiratory rate >30/min SpO2 < 90%), ARDS and septic shock [6]. HbA1c implementation using HPLC methods and D-dimer is measured by ELISA method. Result: There were 163 patients consisting of 92 men and 71 women, the average age was 56.9±10.3 years, and HbA1c, FPG and PPG remained uncontrolled. There were no differences in age parameters of blood sugar profiles and D-dimers between men and women. D-dimers are significantly negatively correlated with PPG. Conclusion: Age, blood sugar profile and D-dimer did not differ significantly between men and women, and D-dimer had a correlation significantly with PPG on T2DM with COVID-19 patients. Keywords : D-dimer, T2DM, COVID-19

ASSOCIATION OF CHILD-PUGH SCORE WITH RENAL DYSFUNCTION IN LIVER CIRRHOSIS PATIENTS

Background Renal dysfunction remains a common and serious complication in cirrhotic patients and affecting the prognosis of the patient. Early prevention, diagnosis, and treatment are important to avoid any morbidity and mortality caused. This study aims to evaluate the association between the Child-Pugh score and its parameters with renal dysfunction in liver cirrhosis. Method This study was a retrospective cross-sectional by design. This study was conducted at Adam Malik General Hospital with a total sampling of liver cirrhosis inpatients in January 2017-December 2018 periods. Result Total 259 patients were included with data collected from the medical record. The results of statistical analysis with Chi-square and Fisher’s Exact founded an association between Child-Pugh (p=0.003) and ascites (p=0.014) with renal dysfunction in liver cirrhosis patients. Meanwhile, hepatic encephalopathy was not found in an association with p-value=0.144. Mann-Whitney test used to evaluate median differences of albumin, bilirubin and international internalized ratio (INR) in groups of liver cirrhosis with and without renal dysfunction. The results, albumin was found significant differences with p-value=0.017. Bilirubin and INR were found no significant differences (p>0.05). Conclusion It was concluded association found between Child-Pugh score with renal dysfunction in liver cirrhosis patients.

Brown Tumor of Lower Right Limb in Patients With Primary Hyperparathyroidism: A Case Report

Background.Brown tumor of Hyperparathyroidism is a metabolic disorder that can affect the entire skeleton and reactive process due to bone resorption caused by primary or secondary hyperparathyroidism (HPT). Brown tumors can occur as solitary or multiple lesions in any bone, most often in the pelvis, ribs, clavicle, mandibula, and extremities. Here, we report the Brown tumor in the lower right limb in patients with primary HPT, and the literature is reviewed. Case presentation. Patients was women 30 years old had married and come with main complains of difficulty walking. This condition has been experienced by patients since diagnosis with lunb of tibia last 8 months and caused pain from hip to lower leg. On laboratory results, it showed elevated PTH 1.249 (normal 15-65) pg/dL, elevated phosphatase alkali 1156 (normal 40-150) u/dL, elevated Ca 10,8 (n:8,6 -10,3) mg/dL, phosphor 2,1 (3–4,5) mg/dL. Histology examination of tibia lump was a benign lesion of bone (Brown Tumor). Ultrasonography transabdominal result revealed kidney stones with bilateral renal pelvis dilation, nephrolithiasis non-obstructive was found with size 1 cm & left kidney cyst with size 0.6 cm. On Neck USG showed giant cyst lesion on parathyroid glands. Radiologist pelvic examination results showed bone metastasis disease. Head CT Scan examination concluded as suspect metastatic bone. Body bone scans examination showed pathological bone metastatic process. Conclusion. Brown tumor in right lower limb caused by primary HPT

Comparison of The Effects of General and Spinal on Apgar Scores of Babies Born Through Caesarean Section in RSUP Haji Adam Malik Medan from 2018 to 2019

Background. General anesthesia and spinal anesthesia in cesarean section both have advantages and disadvantages. The scoring system of APGAR is a standardized tool that can inform the condition of newborn infants, which might be influenced by gestational age, medication, resuscitation, cardiorespiratory and neurological conditions of the mother. This study aimed to compare the effect of general and spinal anesthesia usage to the APGAR score of newborn infants at Haji Adam Malik General Hospital Medan. Methode. This study uses an observational-analytic design with a cross-sectional approach, conducted using secondary data through the medical records of mothers who gave birth through cesarean section and obtained at the Medical Record Installation at the Haji Adam Malik Hospital Medan from 2018 to 2019. Result. In spinal anesthesia, there are 52 samples for a score of 8-10. Whereas in general anesthesia, there are 52 samples to score 8-10. The APGAR score of 1 minute in infants born through cesarean section under spinal anesthesia had an average of 8.63, with general anesthesia of 8.00 (p=0.001). The 5-minute APGAR score in infants born through cesarean section under spinal anesthesia had an average of 9.85, and with general anesthesia of 8.67 (p=1.000). Conclusion: The 1-minute APGAR score for infants using spinal anesthesia showed a statistically better effect than the 1-minute APGAR score for infants using general anesthesia.

Correlation between Lipid Profile and D-dimer of Covid-19 Patients with Type 2 Diabetes Mellitus

Background. Lipids play a central role in viral infection, as they represent the structural foundations of cellular and viral membranes. The study aimed to examine the relationship between the D-dimer of T2DM patients with the lipid profile parameters of newly diagnosed COVID-19 patients. Method. This study uses secondary data, which is obtained from medical records of H. Adam Malik Medan Hospital between 2020-2021. The population of this study was all inpatients confirmed COVID-19 through RT-PCR SARS-CoV-2 swab examination. Results. There are 163 participants in this study. HbA1c values were high in T2DM patients with Covid-19, while lipid, and D-dimer profile values were still normal. Parameter of HbA1c, lipid and D-dimer profiles between men and women do not differ significantly. D-dimer is not correlated with HbA1c parameters and lipid profiles Conclusion. In this study, HbA1c values were high in T2DM patients with Covid-19, while D-dimer is not correlated with HbA1c parameters and lipid profiles

Correlation Between Carbon Monoxide Level In Exhaled Air and Pulmonary Function On Grill Street-Vendors In Medan City

Background. Air pollution is the result of household waste responsible for 3.8 million death and 7.7% of all mortality over the world. One air pollutant which tends to increase year by year is carbon monoxide (CO). CO is produced as the result of the imperfect combustion of machines and the combustion of charcoal. The purpose of this study is to assess the correlation between CO level in exhaled air and pulmonary function on grill street-vendors in Medan city. Method: This study is an observational analytic with a cross-sectional approach. The subjects were grill in Medan city who fulfilled certain inclusion and exclusion criteria with the consecutive sampling method. This study data is primary data which is collected using a questionnaire, smokerlyzer, and spirometry. Result: The subjects of this study are 25 grill street-vendors. Most subjects in this study have red (40%) and green (32%) zone in CO exhaled test and as in pulmonary function test, restrictive (56%) and mixed-type (40%) are the most. The Spearman correlation result between CO level in exhaled air and pulmonary function FEV1 and FVC are not significant (p=0.068 and p=0.251). Conclusion: There is no significant correlation between CO levels in exhaled air and pulmonary function

Level of Knowledge and Attitude of Kualanamu International Airport Employee About Basic Life Support

All level of communities should be taught about basic life support especially for workers who related to giving first aid, one of them is the airport. Ideally, everyone knows the basic first aid techniques and takes regular training to ensure that the knowledge stays on. Basic life support is an effort made to maintain the life of someone who is in danger which can get worse or death if it’s not treated quickly. Basic life support in the first hour can reduce up to 85% of mortality.

The Correlation between Personal Hygiene and Intestinal Parasitic Infection in Students of SDN 060889, SDN 060894, and SDN 060831 Medan

Background. Intestinal parasitic infections are globally endemic diseases. The presence of parasites in the intestine will lead to growth disturbance. Knowledge of personal hygiene is necessary for responding to an illness or other health problems. This study was conducted to determine the correlation between personal hygiene and intestinal parasitic infections in students. Method. This study is an observational analytic study with a cross-sectional design. Samples of this study were taken from students in grades IV, V, VI of SDN 060889, SDN 060894, and SDN 060831 Medan who met the inclusion and exclusion criteria, as many as 62 people. The research data are primarily collected in the form of questionnaires, and fecal specimens examined microscopically using the Kato-Katz and Ether Formol Concentration method. The data that has been collected will be analyzed using bivariate analysis with the chi-square test. Results. From 62 respondents, it was found that 26 (41.93%) respondents suffer from intestinal parasitic infections. There were 16 (25.80%) respondents who had poor personal hygiene, while 46 (74.19%) others had good personal hygiene. A significant correlation was found between personal hygiene and intestinal parasitic infections in study respondents (p = 0.001). Conclusions. There is a significant correlation between personal hygiene and intestinal parasitic infections in this study

Effects of Monosodium Glutamate on the Weight Gain of Experimental Rats

Background: Obesity, as defined by the WHO is an abnormal fat consolidation or excessive fat deposit. Those excessive fat deposits have been known to be the risk factors for cardiovascular diseases. One such additive is known to improve the taste of the food is Monosodium Glutamate (MSG). The purpose of the study is to determine the effects of MSG on weight gain. Methods: This is a simple experimental design with a pretest-posttest design. The study was conducted in the Animal House laboratories of the Faculty of Mathematics and Natural Sciences Universitas Sumatera Utara between October and November of 2019. The sample in this experiment is male Wistar rats aged 10-11 weeks that will be fed with standard animal feed mixed with MSG. There are 2 groups of rats (each group 16 rats), one group 1 (non-MSG), and group 2 (MSG). The rats were fed with animal feed (ad labium) for 31 days. The feed given every single day will be weighed and documented. The subcutaneous fat was taken from the abdominal and axillary regions. Result. After 31 days of treatment, re-weighing of both groups of animals was carried out. The initial weight, final weight, total weight gain, total fat extracted and total feed consumed was not different significant (p>0,05). Conclusion. The feeding of MSG for 31 days, did not have significant effects on weight gain. A longer time is needed for evaluation of MSG effect on weight gain