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Platelet Large Cell Ratio as a Prothrombotic Biomarker to Predict the Severity of COVID-19 Rikarni, Rikarni; Najirman, Najirman; Yulia, Dwi; Burhan, Ida Rahmah; Amalina
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2622

Abstract

 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the lungs causes alveolar cell inflammation and disruption, leading to increased levels of proinflammatory cytokines that stimulate platelet activation and consumption. In response, megakaryocytes will increase the production of large, immature platelets. Large platelets bind more to fibrinogen than small platelets, increasing the potential for thrombus formation. This study aims to analyze the platelet large cell ratio as a prothrombotic biomarker to predict the severity of thrombosis in patients. A prospective cohort study was conducted in May-November 2021 at M. Djamil Hospital involving 206 samples of confirmed coronavirus disease 2019 (COVID-19) patients. The examinations included platelet count, P-LCR, and D-dimer. Large platelet counts were calculated using the Platelet Large Cell Ratio (P-LCR) parameter with an automated hematology analyzer. Clinical manifestations of disease severity were monitored based on WHO criteria, grouped into non-severe and severe disease. The 3 results showed a mean age of 47.41 (SD = 17.82). Platelet count was 263,690 (116,995)/mm , P-LCR was 30.86 (6.63)%, and D-dimer value was 2,215.97 (2,590.86) ng/mL. The P-LCR in the severe group was 35.08 (8.21)%, and the non-severe group was 26.64 (6.81)%, with p <0.001. D-dimer in the severe group was 3,680.36 (3,006.23) ng/mL, and in the non-severe group, 869.12 (977.03) ng/mL, with p <0.001. The relative risk of a high P-LCR causing severe COVID-19 is 2.35 compared to a low P-LCR, with p <0.001. The relative risk of a high D-dimer value causing severe COVID-19 is 6.80 compared to a low D-dimer, with p <0.001. The conclusion is  that a greater increase in large platelet production occurs in severe COVID-19 disease. P-LCR is a crucial biomarker for evaluating platelet activity. A high P-LCR value is a risk factor for predicting the severity of COVID-19. Suggestions for the use of PLCR. Increased risk of thrombotic events in COVID-19 patients can be identified by P-LCR examination upon admission to the hospital, allowing for preventive treatment.
Behavioral Study of Diabetes Mellitus Patients in Blood Glucose Control: A Phenomenological Study Febriyanti, Febriyanti; Masrul, Masrul; Najirman, Najirman; Indrapriyatna, Ahmad Syafruddin; Yunir, Em; Mudjiran, Mudjiran; Semiarty, Rima; Yulia, Dwi
Indonesian Journal of Global Health Research Vol 6 No S6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6iS6.4918

Abstract

The disease pattern in Indonesia is currently shifting from infectious diseases to degenerative diseases. This pattern is accompanied by the problem of a double burden of disease. The incidence of degenerative diseases is increasing along with changes in lifestyle and environmental behavior. One of the threats of degenerative diseases to public health is diabetes mellitus. The prevalence of diabetes in people aged over 15 years increased from 10.9% in 2018 to 11.7% in 2023. This shows that this disease is not only a problem for the elderly but also affects the productive age group. The main causes include unhealthy diet, lack of physical activity, and obesity. This study aims to observe and explore the behavior of people with diabetes in controlling blood glucose while suffering from diabetes. The research method used in this study is qualitative research with a phenomenological approach, with the informant selection technique using the snowball technique of 25 people. The main instrument of qualitative research is the researcher herself. The researcher is a nurse with a Masters in Nursing. The researcher as a facilitator also uses the tools used in the study as data collection instruments, namely the Digital Voice Recorder in this case the researcher's cellphone (Oppo A92) and interview guidelines and field notes and the researcher conducted in-depth interviews for approximately 3 weeks, data processing and data analysis using the Colaizzi method which consists of seven stages. Based on the results of in-depth interviews with 25 informants, 16 themes of the phenomenon of factors causing uncontrolled blood glucose were obtained, including incorrect knowledge about diabetes, the assumption that diabetes is a harmless disease, boredom factors in managing diet, poor behavior in daily eating habits, taking medication not according to the given dose, rarely or not doing sports activities, having an attitude that ignores the rules in following a diet while suffering from diabetes, information obtained from health workers and family is minimal, information from various media such as the internet is not utilized, limited health workers in providing education, feelings of hopelessness while suffering from diabetes mellitus, feeling that they do not get support from family or health workers in treating diabetes while suffering from diabetes mellitus, alternatives to drugs from the hospital are taking herbal medicines. The phenomenon of the dominant factors causing uncontrolled blood glucose is incorrect knowledge about diabetes, as well as the assumption that diabetes is a harmless disease, as well as boredom factors in regulating diet, and poor behavior in daily eating habits, as well as rarely or never doing sports activities, and having attitudes and behaviors that ignore the rules in undergoing treatment while suffering from diabetes.
PERANAN IL-6 PADA PATOFISIOLOGI DAN TATA LAKSANA ARTRITIS REUMATOID Rozak, Hasbi Abdul; Najirman, Najirman
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 7 No 2 (2024): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Artritis Reumatoid (AR) merupakan penyakit autoimun progresif yang disebabkan oleh inflamasi kronik pada berbagai macam sistem dan organ di seluruh tubuh. Tujuan tinjauan Pustaka ini untuk mengetahui peran IL-6 dalam tata laksana dan patofisiologi dalam AR. Penyakit autoimun ini mampu meningkatkan tingkat mortalitas hingga 3 kali lebih tinggi daripada populasi umum. Patofisiologi terjadinya progresifitas penyakit melibatkan berbagai macam sitokin diantaranya yaitu IL-1, IL-6, dan TNF-α memiliki peran utama untuk memicu sel pannus yang dapat merusak tulang rawan secara lokal dan menghambat pembentukan molekul matrik baru melalui zat kolagen dan enzim proteolitik. Kerusakan sendi berkaitan dengan adanya IL-6 yang dihasilkan secara berlebihan pada serum dan fibroblas sinovium. IL-6 juga meningkatkan produksi ligand (RANKL), receptor activator of nuclear factor-kB (RANK) yang menginduksi ekspresi mRNA, dan meningkatkan resorpsi melalui interaksi RANK/RANKL/osteoprotegerin. Tinjauan pustaka yang ada membuktikan bahwa tocilizumab yang berperan sebagai anti IL-6R memiliki efektivitas yang paling tinggi, serta memiliki risiko efek samping yang paling rendah dibandingkan DMRAD biologi yang lain. Kata kunci : artritis reumatoid, tata laksana, patofisiologi DOI : 10.35990/mk.v7n2.p209-218