Online ISSN: 2515-8260

Author : Bakri, Syakib


Relationship Between Estimated Glomerular Filtration Rate With Plasma Lipid Levels In Non-Dialysis Diabetic Kidney Disease Patients

Cely Palebangan; Haerani Rasyid; Andi Makbul Aman; Syakib Bakri; Husaini Umar; Andi Fachruddin Benyamin; Hasyim Kasim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 935-943

Aims: To assess the relationship between estimated glomerular filtration rate (eGFR) and plasma lipid levels in non-dialysis diabetic kidney disease (ND-DKD) subjects.
Materials and methods : In this cross-sectional study, outpatients from June to September 2020 who had been diagnosed with ND-DKD at Wahidin Sudirohusodo Hospital and Universitas Hasanuddin Hospital were enrolled. Creatinine was examined to determine eGFR based on the chronic kidney disease epidemiology collaboration (CKD-EPI) formulation, lipid profile, and metabolic characteristics. For statistical analysis, Pearson correlation test and Chi-Square test were performed, significant if the p < 0.05.
Results : Of the 103 study participants analyzed with a mean age of 54,7 ± 9,1 years, it was found that the mean showed dyslipidemia, with plasma lipid levels in mg/dl were 254.1; 45.9; 156.2; 191.8 for total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglyceride (TG), respectively, and the mean eGFR value was 61.6 min ml/1.73m2. From the analysis of the relationship between eGFR and plasma lipid levels, it was found that only the HDLc level was significantly associated with eGFR, and this relationship was only influenced by female gender.
Conclusions : There was a significant positive correlation between eGFR and HDLc level in ND-DKD subject where the lower the eGFR, the lower HDLc level.

Expression Of Interleukin-6 Levels In Elderly Sarcopenia

Resliany Rachim; Agus Sudarso; Shanti Pricillia Makagiansar; Syakib Bakri; Haerani Rasyid; A Makbul Aman; Hasyim Kasim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 2837-2844

Background/Aim: Sarcopenia is a syndrome characterized by progressive loss of muscle mass and strength with a risk of adverse clinical outcomes such as physical disability, reduced quality of life, and death. Oxidative stress and inflammatory processes are known as factors that trigger sarcopenia by releasing the catabolic stimuli of IL-6. Based on this we study the dynamics of interleukin-6 (IL-6) in elderly sarcopenia in Wahidin Sudirohusodo Hospital Makassar.Method: This study was an analytic cross-sectional design conducted at the Geriatric Polyclinic of Wahidin Sudirohusodo Hospital, Makassar in March-June 2020. The assessed variables were degree of sarcopenia (probable sarcopenia, sarcopenia, dan severe sarcopenia) based on The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria, age, sex, number of comorbids, and IL-6 levels examination. Statistical analysis was performed by descriptive statistical calculations and frequency distribution as well as the Independent-t statistical test, and Anova test. Results: Studied from 82 subjects (51 females, 62.2%) with the mean of 68.95 years of age. The prevalence of probable sarcopenia was 40.2%, sarcopenia 8.5%, severe sarcopenia 6.1%, and normal 45.1%. IL-6 levels were found to be significantly increased according to the severity of sarcopenia (normal, 52.81 ng/; probable sarcopenia, 67.47 ug/L; sarcopenia, 135.36 ng/L; and severe sarcopenia, 287.99 ng/L). Based on age, IL-6 levels increased significantly with age (60-74 years, 63.28 ng/L; 75 years, 139.35 ng/L). Based on the number of comorbids, IL-6 levels increased significantly according to the number of comorbids (1-3 comorbids, 52.86 ng/L; 4 comorbids (120.84 ng/L). Conclusion: In the elderly subject, IL-6 levels increases according to the severity of sarcopenia. IL-6 levels also increases with age, and the number of comorbids.

Neutrophil Lymphocyte Ratio And Platelet Lymphocyte Ratioassociated With Disease Activity In Patients With Systemic Lupus Erythematosus

Ismunandar .; Femi Syahriani; Faridin HP; Syakib Bakri; Hasyim Kasim; Tutik Harjianti; Sudirman Kat; Haerani Rasyid; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 978-984

Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with no well-known cause. The search for simple laboratory indicators is essential to assess the disease activity of the SLE. Currently, the Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) are widely used as markers of the inflammation.
Methods: A cross-sectional analytic study involving 35 patients who met the criteria by Systemic Lupus International Collaborating Clinics (SLICC) 2012 was conducted during August 2019 until June 2020. The samples were obtained from outpatients and inpatients of the Rheumatology Clinic at WahidinSudirohusodo hospital and its collaborating hospitals. The data of the value of neutrophils, lymphocytes, platelets and disease activity were collected using the Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI).
Results: Of 35 patients with SLE, all were women aged 18-51 years. The result shows that there is a significant relationship between NLR and MEX-SLEDAI scores (p <0.000). Also, PLR is significantly associated with MEX-SLEDAI scores (p <0.000).

Association of bacterial/viral infections withneutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio in patients presenting with fever

Tri Yulia Rini; Satriawan Abadi; Sudirman Katu; Syakib Bakri; Haerani Rasyid; Hasyim Kasim; Andi Fachruddin; Risna Halim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1500-1509

Background of the Study: Bacterial and Viral infections are often hard to be distinguished in daily clinical practice. Biological markers obtained from a routine examination play an important role to minimize time in providing diagnose and giving therapy. Recently, the use of Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) is greatly considered to differentiate types of infection found in the patients presenting with fever.
Method: This study uses prospective cohort study design and involves patients presenting with fever who are admitted to the ICU. The initial NLR, MLR, and PLR is examined and categorized into types of infection found. The ANOVA test and t-test are performed to find out the difference among study groups with the value of α = 0,05.
Result : This study involves 207 patients (92 male patients [44%]) presenting with fever with the average age of 45,6 ± 14,6 years old. The majority of cases (135 cases [66,5%]) in patients with fever results from bacterial infection; The study also finds 47 cases (34,8%) of typhoid fever and 30 cases (22,2%) of pulmonary tuberculosis. Dengue hemorrhagic fever (DHF) is the most commonly found viral infection with 52 cases (76,4%). The significant diagnose of bacterial infection shows higher value of NLR and MLR than that of viral infection (P < 0,001); Urinary tract infection has the highest value of NLR and MLR, amounting to 9,4 ± 3,6 and 0,23 ± 0,20, respectively. In general, the value of PLR is lower than that of viral infection (P < 0,001).
Conclusion: Neutrophil-lymphocyte ratio, MLR and PLR have benefit to predict diagnosis for the patients presenting with a fever. Bacterial infection is associated with the high value of NLR and MLR, and PLR generally has a lower value in viral infection cases.

The Effect Of Highly Active Antiretroviral Therapyon Lipid Profileof Hiv Patients

Vera Bahar; Andi Makbul Aman; Sudirman Katu; Syakib Bakri; Haerani Rasyid; Husaini Umar; Risna Halim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 953-960

Background:The widespread use of highly active retroviral therapy (HAART) has indicated a dramatic reduction in impairment due to immunodeficiency. Several studies have shown that an adverse event of HAART on dyslipidemia and insulin resistance. This study aimed to assess changes in lipid profiles after HAART.
Methods:A prospective cohort study with a consecutive sampling method consists of 59 HIV-infected patientsreceiving HAART at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia, from March-September 2020. Lipid profiles were measured at the initial time and after three months of HAART. The drug regimen was divided into two groups: Regimen 
group 1 (tenofovir, lamivudine, efavirenz), and another regimen group (consist of 4 regimen group combination: zidovudine, lamivudine, efavirenz; tenofovir, emtricitabine, lopinavir/ritonavir; tenofovir, lamivudine, nevirapine, and tenofovir, lamivudine, rilpivirine). ANOVA paired t-test and chi-square test were used for statistical analysis(it is significant if p is<0.05).
Results:The mean age of the subjects was 32.1 ± 6.6 years old. About 76.3% of subjects were male. Regimen 1 was used by 88.1% of the subjects and another regimen only 11.9% of the subjects. There were 27 subjects (45.8%) were underweight. The proportion of subjects with lipid abnormalities after 3 months of HAART significantly higher in LDL-c and TG level (P= 0.002 and 0.021). Regimen group1 showed increased levels of total cholesterol (TC), LDL-c, and TG (P = 0.037, 0.041, and 0.001) after HAART.
Conclusion:Highly active retroviral therapy is associated with lipid profile changes in HIV patients after 3 months of therapy.

The Effects Of Smoking On The Relationship Between Estimated Glomerular Filtration Rate And The Severity Of Coronary Artery Disease Based On Syntax Score

Eko Irawan Sudarmaji; Hasyim Kasim; Pendrik tandean; Syakib Bakri; Faridin HP; Hae-rani Rasyid; Khalid Saleh; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1440-1449

Background: Chronic kidney disease (CKD) is an independent risk factor and caused high morbidity and mortality for coronary artery disease (CAD). Several scoring systems can be used in assessing the severity of CAD, one of which is using the SYNTAX score (SXscore). Smoking is one of the risk factors for the progression of CAD and CKD. Several observational studies have under-reported the smoking factor influencing the rela-tionship between eGFR and SXscore.
Methods: This research is an observational study with a cross-sectional approach conduct-ed at the Wahidin Sudirohusodo Hospital Makassar from July-August 2020. This study involved 62 CAD and CKD patients undergoing angiography. The estimated glomerular filtration rate was based on chronic kidney disease epidemiology collaboration (CKD-EPI).
Coronary angiography results were converted to SXscore and smoking grade based on the Brinkman index.
Results: This study involved 62 CAD and CKD patients male (71%), aged ≥ 55 years (77.4%), hypertension (71%), diabetes (35.5%), smoking (50%), eGFR G3a & G3b (53.9. %) and SXscore medium-high (50%). The results showed that lower eGFR could increase the SXscore (p < 0.001), especially in smoking subjects (p < 0.001). Multivariate analysis showed that gender was the most significant factor contributing to the relationship between eGFR and SXscore
Conclusion : The lower eGFR could increase the SXscore, where this correlation was more significant in smoking patients. Multivariate analysis showed that gender was the most significant factor contributing to the relationship between eGFR and SXscore.

Analysis Of Risk Factors For Pulmonary Tuberculosis Incidence In Type-2 Diabetes Mellitus Patients

Hari Setiawan; Harun Iskandar; Himawan Sanusi; Syakib Bakri; Makbul Aman; Hasyim Kasim; Haerani Rasyid; Nur Ahmad Tabri; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1495-1499

Background:Incidence of pulmonary TB in type-2 diabetes mellitus patients is still high. Gender, age, nutritional status, duration of diabetes, blood glucose control, smoking habit, and HbA1c, are among risk factors that influence its occurrence. This study aims to analyze the risk factors that contribute to the incidence of pulmonary TB in type-2 DM patients in Makassar.
Methods:A survey analysis study at Wahidin Sudirohusodo Hospital. Hasanuddin University Hospital. and educational network hospital.on December 2019 until the desired sample reached. Sample collection using consecutive sampling. Data analysis using SPSS verse 22. Statistical analysis using pearson’s correlation. chi square test. and multiple logistic regression (backward method). Significant result if p value <0.05.
Results:Study included 225 type-2 DM patients. From study shows distribution of pulmonary TB in type-2 DM patients is 13.3%. Incidence of pulmonary TB was high in patient with underweight (OR=6.7 and p<0.05), duration of DM>5 years (OR=3.8 and p<0.05), and uncontrolled blood glucose (OR=2.7 and p<0.05). There was no significant correlation between gender (female 19 from 135, male 11 from 90 with p>0.05), age (age >60yo 15 from 92, age ≤60yo 15 from 133 with p>0.05), smoking habit (yes 10 from 84, no 20 from 141 with p>0.05) and HbA1c (A1c <7 was 0 from 7 and A1c ≥7 was 30 from 165 with p>0.05) with pulmonary TB incidence.
Discussions:Incidence pulmonary TB in type-2 DM patients according to BMI was significant (p<0.05) because condition of malnutrition can lowering the immune status by decreased the limphocytes production and immune proliferation also decreased of IFN-gamma and IL-2 level, and increased of TGF-beta. Incidence according to duration of DM was significant (p<0.05). Incidence according to blood glucose control was significant (p<0.05), DM and uncontrolled blood glucose can lead to an immune compromise condition, some of risk factors that also can contribute to infection disease.
Conclusion:There was significant correlation between underweight, duration of DM >5 years, and uncontrolled blood glucose with pulmonary TB incidence.

Compatibility of Endocan Levels with SOFA Scorein Sepsis Patients at Dr.Wahidin Sudirohusodo Hospital Makassar

RizqahAulyna Rachmat; Sudirman Katu; Risna Halim; Syakib Bakri; Haerani Rasyid; Hasyim Kasim; Muhammad Ilyas; Tutik Harjianti; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 969-977

Background:Sepsis is a life-threatening organ dysfunction and the leading cause of death in critically ill patients. The use of biomarkers and scoring systems is an attempt to assist in the diagnosis and assessing the severity of multi-organ dysfunction. C-reactive protein (CRP), procalcitonin (PCT), and the currently reported marker are endocan. Endocan is a biomarker for multiorgan dysfunction in sepsis. Endocan synthesis and release are triggered by proinflammatory cytokineswhich can increase endocan levels in sepsis while the Sequential (Sepsis-related) Organ Failure Assessment (SOFA) is a scoring method for identifying organ dysfunction in sepsis. A SOFA score ≥2 indicates organ dysfunction. Endocan and SOFA scores are both aimed at assessing multiorgan dysfunction and can determine the prognosis in sepsis. This study aims to determine the suitability of endocan levels with SOFA values in septic patients at Dr.WahidinSudirohusodoHospital Makassar.
Purpose: To determine the suitability of SOFA values with endocan levels in septic patients at the Dr.WahidinSudirohusodoHospital and its network hospital.
Methods: This cross-sectional observational study was conducted from December 2019-August 2020. The population of this study was all sepsis patients in the hospital. 
WahidinSudirohusodo. Data were analyzed descriptively. The compatibility of endocan levels with SOFA values in septic patients used the Spearman correlation test.
Results: From a total of 150 subjects, it was found that patients <60 years were 45 subjects (80.04%), men were 34 subjects (60.7%), patients with 2 comorbid were 21 subjects (37.5%), the mean Endocan levels were 361.9 ± 472.4 with tertileendocan 1 (<110.0) as many as 19 subjects (33.9%) and tertile 3 (> 232.0) as many as 19 subjects (33.9%) while SOFA scores Mean 5.6 ± 3.7 with SOFA scores 0-6 as many as 36 subjects (64.3%). The endocan level in sepsis was significantly lower than the control, namely 361.9 (p <0.01). Based on the Spearman correlation test, it was found that there was a significant negative correlation between endocan levels and the SOFA score (p <0.05). In women, there was a significant negative correlation between endocan levels and SOFA scores (p <0.05), at age <60 years, there was a significant negative correlation between endocan levels and SOFA scores (p <0.05). with the number of comorbid 1, there was a significant negative correlation between endocan levels and the SOFA score (p <0.05).
Conclusion: There is a significant negative correlation between endocan levels and SOFA score in septic patients at Dr.WahidinSudirohusodo Makassar.

Profile of Vitamin D and Interleukin-8 in COPD Exacerbation

Riswan Idris; Muhammad Ilyas; Erwin Arief; Syakib Bakri; A Makbul Aman; Haerani Ra-syid; Hasyim Kasim; Andi Fachruddin Benyamin; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1484-1494

Background: To determine the profile of vitamin D and interleukin-8 (IL-8) in COPD exacerbation.
Method: This research is an analytical study with a cross-sectional approach conducted at the Wahidin Sudirohusodo Hospital Makassar from March-June 2020. Serum levels of vitamin D (25-hydroxyvitamin D) and IL-8 were measured using the ELISA method in 65 exacerbated COPD patients based on clinical examination, chest radiograph, & spirome-try. The exacerbation criteria were based on Anthonisen and divided into two groups ac-cording to the exacerbation frequency in the past year (frequent exacerbations was often ≥ 3 times/year, infrequent exacerbation < 3 times/year) and related to gender, age, nutrition-al status, smoking status based on the Brinkman index, and obstruction degree according to the Global Initiative for Obstructive Lung Disease (GOLD) 2019.
Results: This study consisted of 65 exacerbated COPD subjects (62 men, 95.4%), with age of ≥ 60 years 73.8%, frequent exacerbations of ≥ 3 times/year, 69.3%, vitamin D deficiency status of 76.9 %, and it was found to be significantly lower (15.1 ng/ml) at the frequent ex-acerbations of ≥ 3 times/year (P <0.01). The means of IL-8 levels were 187.48 +68.30 ng/L and found to be significantly higher (206.7 ng/L) in the frequent exacerbations ≥ 3 times/year (P <0.01). In all subgroups according to gender, age, nutritional status, smok-ing status, and obstruction degree, there was a tendency for the lowest vitamin D and higher IL-8 in the frequent exacerbations of ≥3times/year. Conclusion: Vitamin D levels were found to be the lowest and IL-8 was higher in COPD patients with frequent exacerbations of ≥ 3 times/year, compared to those with the infre-quent exacerbations of < 3 times/year.

Family Support as The Key Factor that Influence Quality of Life based on SF-36 among CKD on Hemodialysis Patients

Rusiawati .; Haerani Rasyid; Saidah Syamsuddin; Syakib Bakri; Hasyim Kasim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 198-205

Background: Chronic kidney disease (CKD) is an emerging public health problem that affects 5–10% of the world population. With the availability of recent treatment modalities including renal replacement therapy, the survival of CKD patients has increased considerably which has led to an increased focus on health-related quality of life (HRQoL). Health-related quality of life represents the impact of the disease or its treatment on the subjective feelings of patients about their physical, mental, spiritual, emotional, social, and functional wellbeing. Quality of life among dialysis patients has been shown to be lower as compared to pre-dialysis CKD patients and is an independent risk factor for mortality in dialysis patients. Family support is an important factor that serves as a support system for the patients to face health problems.
Purpose: To examine levels of family support and the correlation of family support and quality of life (QoL) among CKD on hemodialysis (HD) patients.
Methods: This cross-sectional observational study was conducted in August-November 2020 and recruited chronic HD patients from Wahidin Sudirohusodo Hospital in Makassar, Indonesia. The demographic data of HD patients were collected. Quality of life was assessed using the validated Indonesian version of the Short Form-36 (SF-36) questionnaire which consists of Physical Component Summary (PCS) and Mental Component Summary (MCS) and family support that was assessed using the validated “Dukungan Keluarga” questionnaire. The data were analyzed using SPSS version 22.0 statistical software.
Results: A total of 60 subjects (39 males and 21 females) were included. The mean age was 48.9±12.1 years old. About 55% of the subjects was graduated from college. About 86.7% subject was married. About 55% of the subject is not working. About 53.3% of subjects have a family income lower than the regional minimum wage. The mean duration of HD was 22.1±28.6 months. The mean score of family support was 53±8,2. Family support score has a significant positive correlation with each domain of PCS and MCS, the higher score of family support is in accordance with higher score of PCS and MCS.
Conclusion: CKD on HD patients’ quality of life was significantly affected by family support

Systematic Review And Meta-Analysis: Risk Factors Of Acute Kidney Injury In Major Abdominal Surgery

Emminarty .; Hasyim Kasim; Haerani Rasyid; Syakib Bakri; Andi Makbul Aman; Husaini Umar; Muh. Ilyas; Arifin Seweng; Gita vita soraya

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 944-952

Background and objective: Acute kidney injury (AKI) is a common complication in patients undergoing major abdominal surgery. Various recent studies reported an incidence of AKI after surgery ranging from 6.7 to 32%. Risk factors for AKI in this setting may be procedure-related factors, post-operative complications and several patient-related include age, gender, comorbid disease Diabetes Melitus (DM), Hypertension (HT), Cardiovascular disease (CVD), and physical status. This study aimed to explore the risk factors of AKI in major abdominal surgery
Methods: We conducted a systematic literature search from PubMed and Cochrane Library. We included articles describing AKI in the setting of major abdominal surgery, published from 2015 until now, and cohort study design. This review was registered with PROSPERO (CRD42020216405)
Results: From 478 articles, 4 articles met our inclusion criteria describing AKI outcomes in varied population 683-3751. Prevalence of AKI 8,8 %. Age patient risk AKI in major abdominal surgery with Mean difference was 3.04 (95% CI = 1.83-4.25; P <0.00001). Meta-analysis of the four studies showed that Male had a pooled Odds ratio (OR) of 1.79 (95% CI = 1.04-3.08; P = 0.04) , DM OR 1.64 (95% CI 1.36-2.03; P <0.00001), HT pooled OR 1.90 (95% CI = 1.30-2.78; P = 0.0009), CVD has an OR of 1.58 (95% CI = 0.91-2.75; P = 0.10), physical status ASA≥ 3 (The American Society of Anesthesiologists) score has pooled OR 1.70 (95% CI = 1.16-2.49; P = 0.007)
945
Conclusion: Risk factors of AKI in major abdominal surgery setting are higher significantly in male, and patient with comorbid disease DM and HT had a significantly high risk of AKI, as well as physical status score ASA > 3.

The Dynamics of C-reactive Protein Associated with Nutritional Status Changes in Kidney Failure Patients at Initiation and After 3 Months of Dialysis

Trina Primalia Irawanti; Haerani Rasyid; Syakib Bakri; Hasyim Kasim; Andi Makbul Aman; Fabiola Maureen Shinta Adam; Nur Ahmad Tabri; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 152-159

Among kidney failure patients, especially those on dialysis, malnutrition is associated with poor outcomes. Malnutrition is a multifactorial process, including inflammation, which can be measured by C-reactive protein (CRP). The objective is to evaluate the dynamics of CRP associated with nutritional status changes in kidney failure patients at initiation and after 3 months of dialysis. A prospective cohort study using a consecutive sampling method consisting of 40 kidney failure patients who received initial dialysis at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia from January-March 2020. Nutritional status was evaluated with Subjective Global Assessment (SGA), and CRP was measured at the initial dialysis and after 3 months. All subjects received nutritional education at the beginning. Nutritional status was defined as well-nourished (WN, SGA A) and malnourished (MN, SGA B and C), then classified into 4 groups denoting nutritional changes: Group 1 (WN to WN), Group 2 (MN to WN), Group 3 (WN to MN), and Group 4 (MN to MN). ANOVA, paired t-test, and chi-square test (significance p<0.05) were used for statistical analyses. Subject’s mean age was 50.5±14.8 years old; 52.5% were male. Diabetes and obstructive nephropathy were the most frequent underlying diseases, both had a prevalence of 35%. At initiation, the prevalence of malnutrition was 77.5%; after 3 months, it was 70%. The highest proportion of Group 4 were female (62.5%) and those with diabetes (45.9%). Among all subjects, mean CRP decreased (9.4±32.3 mg/dL) after 3 months. While mean CRP based on nutritional changes, Group 2 had the highest reduction (18.8±26.8 mg/dL), and Group 3, CRP increased (17.5±17.0 mg/dL). C-reactive protein is negatively associated with nutritional status changes in kidney failure patients after 3 months of dialysis. Malnutrition was higher in female subjects and those with diabetes.

Correlation of CD4 Count andNeutrophil-Lymphocyte Ratio in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome (HIV-AIDS)Patients

Kartika Handayani; Sudirman Katu; Syakib Bakri; Risna Halim; Andi Makbul Aman; Haerani Rasyid; Hasyim Kasim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 985-993

Background: Human Immunodeficiency Virus (HIV) is an RNA virus that causes a decrease in the immune system and destroys specific white blood cells called T-helper lymphocytes or Cluster of Differentiation 4 (CD4); CD4 is a parameter in HIV-AIDS patients while NLR is a simple parameters that were used to assess inflammatory status.
Purpose: This study aims to determine the relationship between CD4 and NLR levels in HIV-AIDS patients.
Methods: This is an observational study with a cross-sectional design conducted in September 2019-September 2020. The study populations were all HIV patients that hospitalized and outpatient at Dr. Wahidin Sudirohusodo Hospital and his network hospital. Data were analyzed descriptively to found out the association between CD4 and NLR levels in HIV-AIDS patients using the Spearman trial.  Results: A total of 150 subjects, consist of 62 (41.3%) subjects at age 30-39 years, 122 (81.3%) male subjects, 108 (72%) subjects who had PEM nutritional status, and 102 subjects (68%) subject with CD4 count <50. Based on the Spearman test, there is negative correlation of CD4 and NLR in HIV-AIDS patient.
Conclusion: There are significant negative correlation between CD4 and NLR in HIV-AIDS patients at Dr. Wahidin Sudirohusodo Makassar, which higher NLR correlates with the lower value of CD4..

Changes of Electrocardiography Based on Disease Severity in Dengue Hemorraghic Fever

Ivan Tanawal; Idar Mappangara; Sudirman Katu; Syakib Bakri; Haerani Rasyid; Pendrik Tandean; Risna Halim; Hasyim Kasim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 149-151

Dengue virus (DENV) infection is a global health threat affecting at least 3.6 billion people living in more than 125 countries in the tropics and subtropics.1 Dengue hemorrhagic fever(DHF) is one of the public health problems in Indonesia that increasingly widespread.2 In 2018, the total incidence of dengue fever in Indonesia were 65,602 cases, with 467 deaths. The DHF morbidity rate in 2018 decreased compared to 2017, from 26.10 to 24.75 per 100,000 population. The morbidity rate in South Sulawesi Province, Indonesia, was 24.1 per 100 000 population, and the case fatality rate was 0.9%.2 Dengue fever (DF) and DHF are infectious diseases caused by the dengue virus, which belongs to the flavivirus genus, the flaviviridae family. The disease can present as a mild self-limiting illness, DF, or as the more severe forms of the disease, DHF and dengue shock syndrome (DSS). All four dengue virus serotypes (DENV-1, DENV-2, DENV-3 and DENV-4) can cause dengue. Clinical manifestation of severe dengue includes severe bleeding, severe organ involvement and severe plasma leakage.1