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All Journal Global Medical and Health Communication Smart Medical Journal Jurnal Biomedika dan Kesehatan
Hermawati, Berty Denny
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Correlation of Interleukin-6 Level with Neutrophil to Lymphocyte Ratio and Disease Severity in COVID-19 Patients Apriningsih, Hendrastutik; Prabowo, Nurhasan Agung; Reviono, Reviono; Anindita, Brigitta Devi; Myrtha, Risalina; Putri, Desy Puspa; Hermawati, Berty Denny
Global Medical & Health Communication (GMHC) Vol 11, No 1 (2023)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29313/gmhc.v11i1.9643

Abstract

Coronavirus disease 2019 (COVID-19) causes severe acute respiratory disease in humans and has spread rapidly worldwide since its first identification in December 2019. The neutrophil-to-lymphocyte ratio (NLR) describes the balance between the severity of inflammation and the immune system to be used as an important systemic inflammatory marker. Rapid progression of clinical deterioration is characterized by severe respiratory symptoms related to high levels of pro-inflammatory cytokines, like interleukin-6 (IL-6), indicating that the occurrence of cytokine storms leads to increased mortality. This study aims to assess the correlation between IL-6 and NLR in predicting the severity of COVID-19. This prospective cohort study was conducted at the COVID-19 ward of Universitas Sebelas Maret Hospital in August–September 2021. This study involved 66 COVID-19 patients >18 years old with asymptomatic to critical degree and Charlson Comorbidity Index (CCI) value ≤3. Examination of laboratory parameters and serum IL-6 was carried out when the patient entered the Emergency Room. Statistical test with Pearson’s correlation test, significant if p<0.05. There is no significant correlation between IL-6 and NLR with p=0.56 and r=0.08, and a strong correlation between IL-6 and disease severity with p=0.000 and r=0.454. The conclusion is that IL-6 does not correlate with NLR and strongly correlates with disease severity in COVID-19 patients.
ST-Depresi pada Infark Miokard Akut dengan Elevasi Segmen ST–Pentingnya Perubahan Resiprokal pada Elevasi Segmen ST yang Minimal Myrtha, Risalina; Wijayanto, Matthew Aldo; Putri, Desy Puspa; Hermawati, Berty Denny
Jurnal Biomedika dan Kesehatan Vol 7 No 3 (2024)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2024.v7.339-344

Abstract

Coronary artery disease remains the leading cause of mortality globally. Management of ST-elevation myocardial infarction (STEMI) starts from the point of first medical contact. Time delay to treatment influences the mortality in STEMI patients. The aim of this study is to underline the importance of reciprocal ECG changes in helping diagnosis STEMI with subtle ST elevation. We present an obese and hypertensive male patient with atypical symptoms of MI and was diagnosed as peptic ulcer. The ECG showed subtle ST elevation in inferior ECG leads and reciprocal changes in I and aVL. Highly sensitive troponin was elevated. Serial ECG showed evolution, thus revealed acute inferior MI. Successful percutaneous coronary intervention was performed. ECG is one of the most important diagnosis tools in STEMI and a cornerstone to direct the decision to immediate reperfusion therapy. Minimal ST-elevation often leads to inappropriate diagnosis, thus delayed the time to reperfusion. A study shows that 11-23% of STEMI do not reach the cutoff for accepted ECG criteria. In a study of infarctions with minimal ST-elevation, reciprocal changes are reported in 58% of all cases. Reciprocal ECG changes is extremely useful to help identifying STEMI in the absence of obvious ST-elevation on ECG
Case Report: Pneumonia Provocate Thyroid Storm in Graves Disease Hermawati, Berty Denny; Prabowo, Nurhasan Agung; Putri, Desy Puspa; Myrtha, Risalina; Apriningsih, Hendrastutik
Smart Medical Journal Vol 6, No 1 (2023): April
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i1.68166

Abstract

Introduction: A thyroid crisis is an endocrine emergency involving many organ systems and can be fatal to the patient's survival. Although cases of thyroid crisis are rare, the mortality rate is significant which reaches 20–50%. The presence of comorbidities such as pneumonia infection increases the risk of death dramatically. Infection is a factor that can trigger thyroid crisis and exacerbate thyrotoxicosis. This condition of thyroid crisis most often occurs in people with hyperthyroidism caused by Graves' disease. We present the case of a patient with Graves' disease, aged 22 years, who developed a thyroid crisis due to community-acquired pneumonia infection. This study aims to provide a case report regarding the thyroid crisis due to pneumonia.Results: We carried out a physical and some appropriate supporting examinations to confirm the diagnosis. Wayne's index was 26, indicating hyperthyroidism. Assessment with Burch-Wartofsky obtained a score of 45, indicating suspicion of a thyroid storm. Then supportive care was provided to the patient. The community-acquired pneumonia as a triggering factor was treated with antibiotics. Thyrotoxicosis conditions were treated with antithyroid, beta-blocker, and glucocorticoid drugs. The patient's condition improved after treatment.Conclusion: It is crucial to detect and treat thyroid storm as quickly as possible since it has a high mortality rate. Wayne's score is useful for identifying hyperthyroidism based on clinical symptoms. The Burch-Wartofsky Point Scale scores are used to diagnose thyroid storms. Thyroid storm should be managed according to PERKENI (Perkumpulan Endokrinologi Indonesia) and ATA (American Thyroid Association) recommendations. This case serves as an example of how to make a proper diagnosis and treatment to prevent morbidity and death due to thyroid crisis.
Thyroid Crisis and Diabetic Ketoacidosis in Uncontrolled Diabetes Putri, Desy Puspa; Prabowo, Nurhasan Agung; Hermawati, Berty Denny
Smart Medical Journal Vol 6, No 3 (2023): December
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i3.66806

Abstract

Introduction: Thyroid crisis is a medical emergency that causes damage to various organs of the body so that proper diagnosis and immediate treatment are needed. Excess thyroid hormone also affects blood sugar metabolism, especially in diabetic patients. The occurrence of thyroid crisis in conjunction with diabetic ketoacidosis (DKA) is rare, and the exact pathogenesis is still being investigated. We report a case of thyroid crisis in a DKA patient.Case Presentation: A 35-year-old woman was brought by her family to the ER due to a loss of consciousness since 6 hours before admission to the hospital. The patient was said to have complained of fever, shortness of breath, palpitations since the previous day. The patient has a history of uncontrolled Type 2 Diabetes Mellitus (DM) since 5 years ago. Physical examination showed somnolence, blood pressure 120/72 mmHg, pulse rate 126 beats per minute, irregular, respiratory rate 28 breaths per minute, fast and deep breaths. Investigations showed blood sugar 320 mg/dL, uncompensated metabolic acidosis, ketonuria. The patient received DKA therapy, but her consciousness and pulse rate had not improved. TSH levels was low with an increase in fT4 levels, with the Burch-Wartofsky score supporting a thyroid crisis. The patient then received treatment for thyroid crisis and her clinical condition showed significant improvement.Conclusion: The occurrence of thyroid crisis along with DKA is a life-threatening emergency. Untreated hyperthyroid induce severe hyperglycemia and causes acute condition in both organs.  
The Relationship Between Stress and Eating Habits and the Occurence of GERD in Medical Students Puspitasari, Aldayanti; Sukmagautama, Coana; Sari, Amelya Augusthina Ayu; Hermawati, Berty Denny
Smart Medical Journal Vol 7, No 2 (2024): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v7i2.85024

Abstract

Introduction: Gastro Esophageal Reflux Disease (GERD)is a disorder when food that has entered the stomach, goes back up into the esophagus or reflux, from several literature that has been read, in Indonesia many people experience this due to excessive stress, researchers develop existing research using the object and focus of research different. Research was conducted to determine the relationship between stress and eating patterns consisting of regular eating, consumption of spicy food, and consumption of fatty foods in UNS medical faculty students.Method: The research carried out was quantitative research with an observational analytical design and a cross-sectional approach. The research was conducted at the Faculty of Medicine, Universitas Sebelas Maret with a sample of 102 students, namely students from the Faculty of Medicine class 2020-2022. In collecting data, researchers used the GERD-Q questionnaire, the meal pattern questionnaire, FFQ and PSS. Followed by analyzing the data through editing, coding, scoring, tabulating, univariate, bivariate and multivariate analysis.Results: (1) There is a significant relationship between stressful conditions and the incidence of Gastroedophageal Reflux Disease (GERD) in UNS medical students; (2) there is a significant relationship between eating habits consisting of regular eating, consuming spicy food, consuming oily food and the incidence of Gastroedophageal Reflux Disease (GERD) in UNS medical students; (3) Based on a multivariate test, it was found that the most significant independent variable in the incidence of Gastroedophageal Reflux Disease (GERD) in UNS medical students was the habit of consuming oily/fatty foods which was 2 times faster in triggering the occurrence of GERD.Conclusion: From the discussion presented, it can be concluded that there is a significant relationship between stress and eating habits and the occurrence of GERD.
Co-Authors Anindita, Brigitta Devi Apriningsih, Hendrastutik Myrtha, Risalina Nurhasan Agung Prabowo Puspitasari, Aldayanti Putri, Desy Puspa Reviono Reviono Sari, Amelya Augusthina Ayu Sukmagautama, Coana Wijayanto, Matthew Aldo