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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Loe, Luse
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Perbedaan Parameter Hematologi Neutrophil to Lymphocyte Ratio (NLR) Antara Pasien Diabetes Melitus dan Tanpa Diabetes Melitus berdasarkn Derajat Keparahan Sakit Covid-19 Loe, Luse; Soetedjo, Nanny Natalia Mulyani; Permana, Hikmat; Alisjahbana, Bachti
Majalah Kedokteran Indonesia Vol 75 No 1 (2025): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.75.1-2025-1125

Abstract

Background: Patients with diabetes mellitus (DM) have higher risk of complications caused by coronavirus 2019 (COVID-19). COVID-19 virus causes leukopenia and lymphopenia. The neutrophil to lymphocyte ratio (NLR) is a parameter in the complete blood count routinely performed on admission. Method: This study aims to evaluate the difference between NLR in diabetic and non-diabetic patients based on COVID-19 severity. This is a cross-sectional, retrospective, descriptive-analytical study, and the analysis was performed using the comparison test in COVID-19 patients admitted to Hasan Sadikin Hospital from March 2020 to March 2021 using secondary data collected from medical records. There were 612 subjects included in this study. Result: We found a higher NLR median in diabetic (4.1, IQR 2.3-6.2) than non-diabetic (2.9, IQR 2.0-4.0) subjects, with p<0.001. Increased NLR was seen in diabetic COVID-19 subjects with mild to moderate severity, median NLR in diabetic group 4.1 (IQR: 2.3-6.2) vs 2.9 (IQR: 2.0-4.0) in non-diabetic group (p=<0.001). The median NLR was significantly higher in severe-critical diabetic subjects (4.8, IQR 3.0-6.8) than in mild-moderate non-diabetic subjects (2.9, iQR 2.0-4.0). Conclusion: NLR differs between the diabetic and non-diabetic groups depending on the severity of the disease. The NLR is an important parameter in assessing the severity of disease in COVID-19.
Rhabdomyolysis in Thyroid Crisis Soetedjo, Nanny Natalia Mulyani; Loe, Luse; Kusumawati, Maya; Ritonga, Ervita; Permana, Hikmat
Majalah Kedokteran Indonesia Vol 72 No 5 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.5-2022-829

Abstract

Introduction: Hyperthyroidism might lead to rhabdomyolysis. Rhabdomyolysis in thyroid crisis is very rare, currently there are only 7 cases in the world. This is the eight cases in the world that had been reported.Cases: We reported a case of a 46-year-old man with Graves’ Disease who presented with thyroid crisis and rhabdomyolysis.Discussion: The patient came with shortness of breath and palpitations for 10 hours before admission. Tachycardia, tachypnea, thyroid enlargement, motoric weakness, and bilateral lung crackles were noted. The Burch-Wartofsky Point Scale was 60 and the Japan Thyroid Association grade was TS2 first combination. Laboratory showed hyperkalemia (7.7 meq/L), increase in urea (144 mg/dl), creatinine (1.92 mg/dl), fT4 ( greater than 5.0), TSHs (0.06 uIU/ml) creatine kinase (3645 U/L), positive TRAb and Anti-TPO. The patient was treated with thyroid crisis management (propylthiouracil, lugol, dexamethasone) and supportive treatment (dobutamine, digoxin, furosemide, antibiotics, hyperkalemia therapy). After hospitalized for 11 days, the patient was discharged with resolution clinical symptom and levels of CK, urea, and creatinine. Conclusion: Hyperthyroidism might lead to rhabdomyolysis. This condition needs to be recognized and becomes a differential diagnosis in non-traumatic rhabdomyolysis accompanied by acute kidney injury. Therefore, can lead to appropriate and prompt management.
Penanganan Diabetes Sebagai Upaya Mencegah Keparahan COVID-19 Loe, Luse; Soewito, Ferius
Majalah Kedokteran Indonesia Vol 72 No 3 (2022): Journal of the Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.3-2022-840

Abstract

Coronavirus disease 2019 (COVID-19) is one of the leading health problems globally, including in Indonesia. The first case of COVID-19 in Indonesia was discovered on March 2nd 2020. From then until August 7th 2022, 6.244.978 cases of COVID-19 and 157.095 COVID-19-related death have been recorded. A high virus transmission rate, various clinical manifestations, morbidity and mortality caused by COVID-19 alerts clinician to notice some factors which can make a person vulnerable to COVID-19 and which factors contribute to severe COVID-19. Indonesia’s COVID-19 case fatality rate (CFR) is higher than the global CFR. COVID-19 mortality in Indonesia mainly occurs in patients with comorbidity, of which the most common is diabetes mellitus.
Co-Authors Bachti Alisjahbana Ferius Soewito Hikmat Permana Kusumawati, Maya Nanny Natalia Mulyani Soetedjo Ritonga, Ervita