Wahidin Sudirohusodo Hospital Research Articles

The Effect of Makassar Folk Music on Cerebral Hemodynamics Measured by Transcranial Doppler

This study aimed to evaluate the effect of Makassar folk music on cerebral hemodynamics using transcranial doppler (TCD). This was an experimental study with a pre- and post-test design. The study was conducted on 30 subjects at the Sonology clinic of Wahidin Sudirohusodo Hospital, Makassar from August to September 2019. The subjects listened to either rock, classical, or Makassar folk music and cerebral hemodynamic parameters before and after listening were assessed using TCD. The results of the study show that there were significant changes in both the left and the right middle cerebral artery (MCA) mean flow velocity (MFV) after listening to three genres, with a p-value < 0.0001 for each genre. There was no significant difference between the changes observed in left MFV MCA compared to the one on the right side. The value of MFV change was not significantly different across genres. The results indicate that Makassar folk music has the same effect on increasing cerebral hemodynamics as classical music and rock music.

The correlation between the levels of anti-dsDNA IgA antibody and the severity of systemic lupus erythematosus based on cutaneous vasculitis

BackgroundThe purpose of this study was to examine the association between anti double-stranded DNA (anti-dsDNA) IgA levels and the severity of systemic lupus erythematosus (SLE) regarding the presence of cutaneous vasculitis. MethodThe cross-sectional study was conducted at the outpatient installation of Wahidin Sudirohusodo Hospital and Hasanuddin University hospital in Makassar from September 2020 to February 2021. Investigation of anti-ds-DNA IgA levels in SLE patients was performed in two groups: group A (SLE patients with cutaneous vasculitis) and group B (SLE patients without cutaneous vasculitis). The diagnosis of cutaneous vasculitis was based on the presence of efflorescence in the form of erythematous macules and papules, petechiae, urticaria, purpura, nodular lesions and ulcerated lesions. To assess the severity of SLE, the Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI) was employed; the SLE is severe if the value ranges from 11 to 19 and very severe if the value >20. Chi square and Fisher Exact were used in statistical analysis. The results are significant if the p value <0.05. Result54 subjects with SLE patients were identified. The mean age of the subjects in group A was 29.6±7.6 years and in group B 29.9±9.5 years where there were more women in both groups. The most skin manifestations of the entire sample were petechiae with 27.6%. In subjects with positive anti-dsDNA IgA, group A was found to be 100% and significantly higher than in group B at 72.0%. Meanwhile, in subjects with moderate, severe and very severe SLE, the percentages of group A were 37.9%, 48.3% and 13.8%, respectively, which were significantly higher than group B with 20.0%, 44.0%. and 0.0%. Furthermore, in moderate, severe and very severe SLE, the percentage of positive anti-dsDNA IgA (31.9%, 51.1% and 8.5%) was significantly higher than the negative (14.3%, 14.3% and 0.0%). Meanwhile, the mild degree was found to be higher in the negative anti-dsDNA IgA (71.4%) than the positive (8.5%) with p value = 0.002. ConclusionAnti-dsDNA IgA levels are related to the severity of disease in SLE patients based on cutaneous vasculitis. Therefore, anti-dsDNA IgA levels and the presence of cutaneous vasculitis may be useful as the potential predictors of disease severity in SLE patients.

Identifying feeding artery during preoperative embolization of juvenile nasopharyngeal angiofibroma

Treatment of choice and standard of care is surgical resection of the tumor. Nasopharyngeal angiofibromas receive an abundant blood supply mainly from the external carotid branches and partly from the internal carotid artery branches. Many patients are treated with preoperative embolization to minimize the risk of intraoperative hemorrhage and related complications . This retrospective study, we obtained analysis of the medical and imaging records of 11 patients with pathologically proven juvenile nasopharyngeal angiofibroma. Who we performed preoperative endovascular embolization between January 2019 until Desember 202 in Wahidin Sudirohusodo Hospital, Makassar, Indonesia. The procedure was carried out using a cathlab monoplane Philips. A total 11 patients (only 1 female) with juvenile nasopharynx angiofibroma underwent endovascular embolization from 2019-2021 in Wahidin Sudirohusodo Hospital Makassar. Arteriography examination in patients with angiofibroma tumors revealed that the feeding arteries originate from the internal maxillary artery, ascending pharyngeal artery, fascial artery, middle meningeal artery and branches of the internal carotid artery. Identifying the feeding artery before embolization is very important to facilitate the embolization process

ANALYSIS OF VITAMIN D LEVELS IN CHILDREN WITH THALASSEMIA BETA

Background : Beta Thalassemia is a genetic disorder inherited by autosomal recessive and has spread throughout the world, including Indonesia. Beta thalassemia requires lifelong transfusions, which can cause an accumulation of iron in the skin, liver, and kidneys, resulting in a decrease in vitamin D synthesis.Purpose : This study aims to analyze the levels of 25-OH-Vitamin D in beta thalassemia.Method : This study used a cross-sectional design and was conducted at Dr. Wahidin Sudirohusodo Hospital from April to July 2021. The population of this study was patients diagnosed with beta thalassemia and non-thalassemia (controls) who met inclusion criteria. This study compared vitamin D levels in beta thalassemia and non-thalassemia patients.Results : This study involved 60 children aged 6 months to 18 years, who were divided into 2 groups: 30 children in the beta thalassemia group and 30 in the non-thalassemia group. In this study, the levels of 25-OH-Vitamin D were lower in beta thalassemia children compared to non-thalassemic children, with a p value =0.012. Children with beta-thalassemia have a 4.33 times higher risk of vitamin D deficiency compared to non-thalassemic children. With a p value =0.023, 25-OH-Vitamin D levels were significantly lower in beta HbE thalassemia children compared to beta thalassemia major children.Conclusion :Levels of 25-OH-Vitamin D in beta thalassemia children were lower than in non-thalassemic children. Levels of 25-OH-Vitamin D in children with beta HbE thalassemia are lower than in children with beta thalassemia major.

Comparison of Bone Marrow Aspiration Interpretation with Immunophenotyping in Children’s Leukemia Diagnosis

Introduction The prevalence of cancer in children is increasing. The morphological diagnosis of acute leukemia is divided into ALL and AML and is sometimes incompatible with the diagnosis of flow cytometry, which shows the characteristics of malignant cells. This study aims to compare the results of the interpretation of bone marrow aspiration with immunophenotyping in diagnosing childhood leukemia. &#x0D; Methods Data from medical records was used in a retrospective cohort study of children with leukemia (ages 1–18 years) admitted to Dr. Wahidin Sudirohusodo Hospital Makassar from 2013 to 2017. All patients with a working diagnosis of leukemia were examined for bone marrow aspiration, followed by immunophenotyping, and each group was analyzed.&#x0D; Results Of a total of 90 study subjects, the final diagnosis based on immunophenotyping was 60 ALL and 30 AML patients with a mean age of 8 years and 3 months. The male to female ratio was 1.7:1 (p = 0.353). The mean age of the ALL group was 7 years and 10 months, and AML, 9 years (p = 0.409). The suitability of morphology and flow cytometry to ALL and AML was 92.3% and 50%, respectively. Most markers were in the ALL CD 10 and CD 20 groups with a sensitivity of 100% each, and AML CD 117 with a sensitivity of 92%.&#x0D; Conclusion The correspondence between the results of the interpretation of bone marrow aspiration with immunophenotyping in diagnosing ALL 92.3% and AML 50%.

Survival rate comparison of non small cell lung carcinoma patients who are given by epidermal growth factor receptor-tyrosin kinase inhibitor and those given by first-line chemotherapy treatment

Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Wahidin Sudirohusodo hospital. Methods. This study is a retrospective study between 2017 to 2019 from the medical records of NSCLC patients who receive first-line chemotherapy and thise who recieve EGFR-TKI. Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day and or afatinib 1x40 mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 239 subject of NSCLC patients consisted of 135 patients who receive first-line chemotherapy, and 104 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are more than 40 years old (chemotherapy 124 (91.9%) and EGFR-TKI 101 (97.1%) with the male gender that dominates (chemotherapy 98 (72.6%), EGFR-TKI 64 (61.5%). Smoking patients who received first-line chemotherapy are 65.2% and 61.5% of EGFR-TKIs with chemotherapy highest IB (severe IB 28.9%) and for EGFR-TKI (moderate IB are 26.9%). 73.2% of adenocarcinoma histology type with a predominance of stage IV 86.6% (83.7% for chemotherapy and EGFR-TKI 90.4%). Survival rate of patients are 98,7% for 6 months survival, 1 year survival rate is 94.1% and 2 years survival rate of 24.3%. Median survival patients who receiving EGFR-TKI longer than they received first- line chemotherapy (21 months versus 20 months). The 18 months PFS showed that patients treated with EGFR-TKI were 15 months, while patients receiving chemotherapy was 11 months. (P 0.000). Conclusion. Survival rates in NSCLC patients with EGFR-TKI therapy had significantly the highest survival rates compared with all other chemotherapy. Progression was faster in patients with first-line chemotherapy than EGFR-TKI. The factors that most influence the survival rate is type of therapy with p value&lt;0.05.

THE CORRELATION OF JOINT SPACE WIDTH WITH SYNOVIAL FLUID CARTILAGE OLIGOMERIC MATRIX PROTEIN LEVEL IN KNEE OSTEOARTHRITIS PATIENTS

Osteoarthritis (OA) was a degenerative joint disease associated with joint cartilage damage, where the most commonly affected joints are vertebrae, pelvis, knee, and ankle. Pathomechanism of OA includes various etiologies that play a role in the balance destruction and synthesis of cartilage. Radiology examination was the most common method used to monitor the progression of OA but can not show changes in knee OA except in the advanced phase of the disease. Conventional radiology can estimate the thickness of the cartilage through measurement joint space width (JSW). One alternative method that can detect changes in the joint at an early stage of the disease is a measurement of the synthesis and degradation markers of the tissue. Cartilage oligomeric matrix protein (COMP) was one of the cartilage destruction markers of non-aggrecan and non-collagen groups, found in cartilage and other tissues. Several studies have reported the correlation between serum or synovial fluid COMP level with the radiographic progression of knee OA patients. This study aimed to assess the correlation between joint space width and synovial fluid COMP level in knee OA subjects. The study was a descriptive-analytic method with a cross-sectional design in 69 knee OA subjects. It was conducted in the rheumatology outpatient clinic of Wahidin Sudirohusodo Hospital Makassar and its networks on March-June 2015. In this study, we found a correlation between joint space width (JSW) and synovial fluid COMP level, where synovial fluid COMP levels were higher in knee OA subjects with more severe joint space width narrowing, and it was not influenced by age and obesity

Relation between expression of hMLH1 and p53 mRNA genes, in the feces of patients with colorectal carcinoma. Cross-sectional study

Colorectal carcinoma (CRC) is one of the main public health problems. The mortality of CRC is about 8%. Early detection of CRC is very important to prevent death because this cancer could be cured through surgery if the diagnosis can be made as early as possible. Therefore screening strategy for early detection of CRC is critical in reducing mortality. Many investigations supporting the detection of CRC have been developed, including the fecal DNA mutation test using advanced cytological techniques. It is capable of assessing colonocytes for the presence of DNA, RNA, and protein as molecular biomarkers of neoplasia in CRC, including p53 and hMLH1. This study implemented observational approach with a cross-sectional study of the feces of patients with CRC regardless of the stage and grade. The purpose of this study was to determine the expression of the hMLH1 and p53 mRNA genes in the feces of 48 patients with CRC from two hospitals in Indonesia, Siloam Hospitals in Cikarang and Dr. Wahidin Sudirohusodo Hospital in Makassar. The results showed that all adenocarcinoma feces samples with various tumor stages and grades had excess mRNA expression (more than twice the normal amount in Fold Change units) for both the hMLH1 and p53 genes. The average expression of the hMLH1 mRNA gene was the highest at stage two and grade one, while the lowest was at stage four and grade three. In contrast, the average p53 mRNA gene expression was the highest at stage four and grade three, while the lowest was at stage two and grade one. The study suggested that there was a relation between and the expression of hMLH1 and p53 mRNA gene. We concluded that while both hMLH1 and p53 genes in patients’ feces with CRC were overexpressed, they did not significantly affect the grade of CRC.

Analysis of Blood Availability During the COVID-19 Pandemic Period in Blood Bank Dr. Wahidin Sudirohusodo Hospital

Blood Bank's challenge during the COVID-19 era is securing and protecting blood supplies even though countries aretaking precautionary measures with social distancing to prevent or reduce the number of infections caused by COVID-19.This study aimed to compare blood availability before and during the COVID-19 pandemic at the blood bank of Dr. WahidinSudirohusodo Hospital. A Descriptive-analytic study with an observational approach using the Shapiro-Wilk test todetermine the normality of the sample and the paired T-test. Sample data was taken between March-August 2019 andMarch-August 2020. A significant difference was found in blood demand (p-value=0.004), amount of blood transfusion(p-value=0.006), stock and reference report (p-value=0.005), blood service report (p-value=0.005), cito waiting time(p-value=0.002) and regular waiting time (p-value=0.016). There was no significant difference in blood indicator Packed RedCell (PRC) (p-value=0.119). The Large-Scale Social Restriction Policy (PSBB) and reduction of elective surgery in hospitalsaffect the fulfillment of Blood Bank and faster attendance time of blood during the pandemic. The decrease in a number ofblood demands during the COVID-19 pandemic affected the number of blood transfusions, blood service reports, stocks,referrals, and cito and regular waiting time services.

Comparison of Blood Gas Analysis on Hemodialysis in Patients with Chronic Kidney Diseases

Chronic Kidney Disease (CKD) is defined as a renal failure that has lasted for more than three months. Hemodialysis is thetype of kidney replacement therapy that is mostly used, and blood gas analysis can be used to identify this condition. Thisstudy is to compare the blood gas analysis on pre-and post-dialysis in patients with CKD using pH, PaCO , PaO , HCO , SO , 2 2 3 2and BE as markers of improvement in the patients'condition. The population was all patients diagnosed with CKD andhemodialysis at Wahidin Sudirohusodo Hospital, and eligible according to the criteria in this study. The sample size wasdetermined using Federer's calculation, and the statistical analysis using paired T-test and Wilcoxon signed-rank test withα=0.05. Subjects were 34 patients, consisting of 18 females (52.9%) and 16 males (47.1%). Hemodialysis had the mostsignificant impact on the PaO and SaO variables. Relation between PaO and SaO was illustrated in a sigmoid curve. 2 2 2 2Oxygen-bound hemoglobin increased after the first molecule was bound. An almost full PaO pressure will cause a slight 2increase in SaO . Whereas at &lt;90% saturation, a slight decrease in PaO will cause a large decrease in SaO . PaO and SaO 2 2 2 2 2determine cardiac efficiency and the markers for assessing the metabolic conditions of the lungs and heart that correlatewith oxygen. Chronic kidney disease patients experienced improved conditions after undergoing hemodialysis withincreased blood gas values, especially in PaO and SaO .

Severity-dependent variations of the neutrophil to lymphocyte ratio (NLR) in peripheral vestibular vertigo

BackgroundPeripheral vestibular vertigo is a common cause of vertigo especially in the elderly. The neutrophil to lymphocyte ratio (NLR) is a rapid and cost-effective inflammatory marker that has been assessed previously in peripheral vestibular disorders. However, its relation to the severity of peripheral vertigo has not been previously investigated. The aim of this study is to assess the levels of NLR in peripheral vestibular vertigo of various severity categories. This was a cross-sectional study at the Wahidin Sudirohusodo Hospital and Hasanuddin University Teaching Hospital in Makassar. The NLR was measured among subjects with periphel vestibular vertigo with severity categorised using the Dizziness Handicap Inventory (DHI) questionnaire.ResultsA total of 39 participants with peripheral vestibular vertigo were recruited. A statistically significant difference was found (p = 0.002, Kruskal–Wallis ANOVA) between the mean NLR for the mild, moderate, and severe DHI categories were 2.47 ± 1.66, 2.64 ± 0.96, and 5.15 ± 2.59 respectively.ConclusionA significant difference in the NLR was found between the three different vertigo severity groups, wherein NLR values rise with increase in vertigo severity. This warrants further exploration on the role of inflammatory biomarkers in vertigo pathophysiology and clinical assessment.

Antibiotic Susceptibility Pattern in Clinical Isolates of Pseudomonas aeruginosa

Introduction: Pseudomonas aeruginosa is an opportunistic pathogen and causes of nosocomial infections in hospitals. Due to high antibiotic resistance and the ability to develop new resistance during antibiotic treatment, Pseudomonas aeruginosa infection is difficult to eradicate because the physical treatment becomes difficult and ineffective. This study was conducted to evaluate the antibiotic sensitivity pattern of Pseudomonas aeruginosa strains at two different hospital in Makassar. Methods: This study is a cross-sectional study from March to May 2021. The research samples were taken from the results of culture and antibiotic sensitivity tests conducted at two different hospital, Hasanuddin University Hospital and Dr. Wahidin Sudirohusodo Hospital for the period January 1 to September 30, 2019. A total of 84 samples were cultured and tested for antibiotic sensitivity of Pseudomonas aeruginosa. Results: Antibiotic sensitivity of Pseudomonas aeruginosa was best with aminoglycoside antibiotics, gentamicin (100%) at Hasanuddin University Hospital and amikacin (95.8%) at Dr. Wahidin Sudirohusodo Hospital. At Hasanuddin University Hospital followed by antibiotics amikacin (92.3%) and meropenem (84.6%). At Dr. Wahidin Sudirohusodo Hospital, Pseudomonas aeruginosa also showed good sensitivity to gentamicin (91.5%) and meropenem (77.5%). The sensitivity of Pseudomonas aeruginosa was lowest to piperacillin/tazobactam. Conclusions: This study shows that the level of effectiveness of the antibiotics meropenem, amikacin and gentamicin is high enough and it can be used as a treatment option in Pseudomonas aeruginosa infection. This study can help as a reference to prevent mortality and morbidity associated with Pseudomonas aeruginosa infection.

A discrepancy of blood group A with missing antigen in anorectal malformation patient at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia

Background: Blood group discrepancy is a discrepancy in the results of the cell grouping with serum grouping examination. The source of discrepancy is from technical errors or a patient's medical status such as age, disease, history of blood transfusion and medication, pregnancy. This case study aims to evaluate a discrepancy of blood group A with missing antigen in anorectal malformation patient at Dr. Wahidin Sudirohusodo Hospital, Makassar, IndonesiaCase Presentation: A male baby, 6 months 19 days old, was unable to defecate since birth post-colostomy. Physical examination reveals anemia. A routine blood test showed a hemoglobin level of 8.8 g/dL. The diagnosis was high position anorectal malformation post colostomy suspect Hirschsprung Disease, with 110 cc Packed Red Cell (PRC) transfusion plan. A routine pre-transfusion procedure was performed. It was found a discrepancy of blood group A with missing antigen. Crossmatching with blood groups O and A both gave compatible results. Examination of peripheral blood smear after PRC blood group A transfusion found no signs of hemolytic.Conclusion: Blood group discrepancy, in this case, was due to missing antigen, which was caused by the possibility of gastrointestinal bacterial infection.

Concordance between Triglyceride Glucose Index and Admission Insulin Resistance Index in Non-diabetic Subjects of Acute Coronary Syndrome

BACKGROUND: Acute coronary syndrome (ACS) is the leading cause of death in the world and is closely related to insulin resistance (IR). The examination of the triglyceride glucose (TyG) Index and admission IR index (AIRI) can be an alternative examination to assess IR. AIM: The aim of the study was to analyze the concordance between the TyG index and AIRI in assessing IR in nondiabetic subjects of ACS. METHODS: This study was a cross-sectional study using secondary data from ACS patient medical records in Wahidin Sudirohusodo Hospital Makassar from September 2020 until April 2021. An examination of RBG, TyG, and fasting insulin was performed. The statistical test results were considered significant if the p &lt; 0.05. RESULTS: This study included 67 subjects, of which 54 were male and 13 were female, there were 24 people aged &lt;50 years, 43 people aged 50 years old, with a mean of 55.15 ± 12.71 years, a diagnosis of ST-elevation myocardial infarction (STEMI) 25 people, non STEMI 34 people and unstable angina pectoris 8 people, p &lt; 0.05. The receiver operating characteristic curve showed that the cut-off value of the TyG index in predicting AIRI was 3141, with a sensitivity of 88.98% and specificity of 59.09%. The OR value revealed that subjects with a TyG index of &gt;9.06 indicated an 11-time greater risk for IR than subjects with a TyG index ≤9.06. CONCLUSIONS: There was a significant concordance between the TyG index and the AIRI in non-diabetic acute coronary syndrome patient.

The Correlation of Transaminase Enzymes on the Prognosis of Covid-19 Patients in the ICU Infection Center Dr. Wahidin Sudirohusodo General Hospital Makassar

Corona Virus Disease 2019 (COVID-19) is an infectious disease that has been designated as a worldwide pandemic. Symptoms of Covid-19 are not only respiratory symptoms but also extrapulmonary symptoms, including the discovery of impaired liver function in the form of increased transaminase enzymes. Therefore, this study was conducted to see the correlation of transaminase enzymes with the prognosis of COVID-19 patients treated in the Intensive Care Unit (ICU) Dr. Wahidin Sudirohusodo Hospital. The study was conducted on June to August 2021. The cross-sectional analytical research method used retrospective medical record data for the period from July to December 2020 with a sample of 137 patients with COVID-19 confirmed. From the results of the Pearson test, patients with increased SGOT were associated with a mortality prognosis (p=0.000, p&lt;0.05) with a correlation coefficient (r) of -0.383 and an increase in SGPT were associated with a mortality prognosis (p=0.013, p&lt;0.05) with a correlation coefficient (r) of -0.211. From the results of the Kruskal Wallis test, there were differences in prognosis in patients with increased SGOT and SGPT grades 1,2,3, and 4 (p = 0.000 and p = 0.028). There is a correlation between the increased transaminase enzymes with the prognosis of the patient's mortality. Patients with severe elevated SGOT and SGPT enzymes had a greater prognosis of mortality than those with mild enzyme elevations. Extrapulmonary symptoms of stroke were associated with increased SGOT and myocardial infarction symptoms, and nephropathy was associated with increased SGOT and SGPT. Comorbid coronary artery disease and hepatitis were associated with increased SGOT and SGPT.

Ischemic Stroke in a Young Adult Female Caused by Takayasu’s Arteritis: A Case Report

Takayasu's arteritis is one of the causes of ischemic stroke at a young age, but the occurrence is still rarely reported in Indonesia. Here we report the case of a 19-year-old Indonesian female who was admitted to the Wahidin Sudirohusodo Hospital with a sudden onset of right-sided hemiplegia. Other features of Takayasu’s arteritis were observed, including a discrepancy of more than 10 mmHg between the left and right arm systolic blood pressure, claudication of the extremities, and decreased brachial artery pulse. Left hemisphere cerebral infarction was confirmed on the computed tomography (CT) scan. Angiogram abnormalities were also present, showing occlusion of the left proximal inner carotid artery after branching at the aortic arch, and occlusion of the left subclavian artery. Although no fever was observed on presentation, the patient had an elevated erythrocyte sedimentation rate (ESR) of 44 mm/hour. In conclusion, Takayasu’s arteritis should be considered as a potential cause of ischemic stroke in young adults.

EFFECT OF GREEN TEA EXTRACT ON MODULATING THE ANTIBACTERIAL ACTIVITY OF STANDARD ANTIBIOTICS AGAINST THE CLINICAL ISOLATES OF Acinetobacter baumannii

Most of the clinical isolates of Acinetobacter baumannii are found resistant to the β-lactam antibiotics. This research aimed to determine the ability of green tea extract in modulating the antibacterial activity of standard antibiotics amoxicillin, cefotaxime, and imipenem against the clinical isolates of A. baumannii. The clinical isolates used in this study were collected from the Laboratory of Clinical Pathology, Wahidin Sudiro Husodo Hospital Makassar, Indonesia. To determine whether the bacterial isolate is resistant, the experiment was carried out using disk agar diffusion and Vitek-2 methods. Further, the antibacterial activity of the green tea, selected antibiotics, and their combination was determined by using a checkerboard microdilution assay. Results of the study revealed that among the selected two clinical isolates one of the A. baumannii isolates was found resistant to selected standard amoxicillin-clavulanate, cefotaxime, and imipenem, while the other one was found sensitive. Further, green tea extract with a concentration of up to 1.2 mg/ml didn't have any significant effect on the inhibition of A. baumannii growth. Similarly, at the same concentration (1.2 mg/ml) no modulation effect of green tea extract was reported on the antibacterial activity of amoxicillin, cefotaxime, and imipenem against the A. baumannii isolates.

Maternal Age Distribution of Down-Syndrome at Pediatric Growth and Development Clinic, 2015-2019

Introduction: Down Syndrome is a common chromosome abnormality among infants. This condition is Present in 1 over 800 deliveries. Advanced maternal age is a risk factor for Down syndrome. Other miscellaneous factors are radiation, infection, autoimmune and paternal age. The Aim is to determine maternal age distribution of Down syndrome at pediatric growth and development polyclinic, Wahidin Sudirohusodo hospital.&#x0D; Methods: A Descriptive study. Study population was all outpatients at Pediatric Growth and Development polyclinic, Wahidin Sudirohusodo hospital in Makassar 2015-2019. Samples in this study were collected from total sampling of population data that met the criteria of new Down syndrome patients with complete medical records&#x0D; Results: This study found 237 new pediatric down syndrome patients admitted to growth and development polyclinic from January 2015 – December 2019, 95 complete medical records from 237. 52% (49) boys, 48 % (46) girls from 95 children. No gender difference was found in the presentation. Parental age of Down syndrome patients, the most advanced maternal age was &gt;35, found 46 (48,42%), the most advanced paternal age was &gt;35, found 63 (66,32%). Parity &lt; 3rd, the most maternal age between 25-35 (23,16%), parity &gt; 3rd, the most maternal age was &gt;34, found 30 (31,57%).&#x0D; Conclusion. Advance maternal and/ or paternal age is a risk factor of Down Syndrome.

Risk factors of death among children with Dengue Hemorrhagic fever

Background: Dengue hemorrhagic fever (DHF) is still periodically around developing countries including Indonesia. Morbidity and mortality of DHF can be reduced if early diagnosis and appropriate management.&#x0D; Objective: Our study evaluate risk factors of death in pediatric DHF patients hospitalized in Wahidin Sudirohusodo Hospital Makassar.&#x0D; Methods: we review the medical records of patients aged ≤ 18 years from January 2016 to December 2018 with confirmed DHF based on WHO criteria and serologically positive anti-dengue Ig M or positive anti-dengue IgM and Ig G.&#x0D; Results: During the study period, 70 patients aged 1-17 years with the complete medical records enrolled in this study. The DHF severity consisted of 37 cases (52,9%) with shock(DSS) and 33 cases (41,7%) without shock and mostly of them was admitted to the hospital on &gt; 3 days of fever (63 cases /90,0%). Boys were predominantly (39/55,7%) found than girls (31/44,3%) and the majority of cases above 5 years (50/71,4%) with well-nourished patients in 46 cases (65,7%). The hematocrit level ≥ 40 mg/dl, platelets ≤ 40.000/mm3, and leukocyte ≤ 4000 mm3/l were observed in 41 cases (58,6%), 36 cases (51,4%), and 48 cases (68,6%); respectively. Death was observed in four girls (5.7%) (p 0,034/OR 1,148/ 95% CI 1,003 - 1,315) with DSS because of severe condition on admission.&#x0D; Conclusions: Girl was an independent risk factor of death among children with DHF. &#x0D;

Correlation of AGR2 expression with the incidence of metastasis in luminal breast cancer.

AGR2 expression is associated with luminal breast cancer. Overexpression of AGR2 is a predictor of poor prognosis. Several studies have found correlations between AGR2 in disseminated tumor cells (DTCs) in breast cancer patients. This study aims to determine the correlation between anterior Gradient2 (AGR2) expression with the incidence of distant metastases in luminal breast cancer. This study was an observational study using a cross-sectional method and was conducted at Wahidin Sudirohusodo Hospital and the network. ELISA methods examine AGR2 expression from blood serum of breast cancer patients. To compare the AGR2 expression in metastatic patients and the non-metastatic patient was tested with Mann Whitney test. The correlation of AGR2 expression and metastasis was tested with the Rank Spearman test. The mean value of AGR2 antibody expression on ELISA in this study was 2.90 ± 1.82ng/dl, and its cut-off point was 2.1ng/dl. Based on this cut-off point value, 14 subjects (66.7%) had overexpression of AGR2 serum ELISA, and 7 subjects (33.3%) had not. The mean value AGR2 was significantly higher in metastatic than not metastatic, 3.77 versus 1.76 (p <0.01). The Spearman rank test obtained a p-value for the 2 tail test of 0.003 (p <0.05), which showed a significant correlation of both, while the correlation coefficient of 0.612 showed a strong positive correlation of AGR2 overexpression and metastasis. AGR2 expression is correlated with metastasis in Luminal breast cancer.