Background

Pathogenesis of severe dengue infection has not been elucidated. Immune complex of pre-existing antibodies and heterotypic dengue virus bind to FcγII (cluster of differentiation (CD32)) receptor (FcγIIR) on monocyte facilitates entry and replication of dengue virus. Aim of this study was to evaluate the expression of FcγIIR on monocytes in patients infected with dengue and in healthy subjects.

Methods

This study used a cross-sectional design that included patients infected with dengue who were hospitalized in Dr. Sardjito General Hospital, Panembahan Senopati Hospital, and Sleman Hospital, who met the inclusion criteria and selected consecutively. Examinations were completed using a lyse, no-wash method of flow cytometry. Computerized statistical analysis was conducted and was considered to be significant if p<0.05.

Results

Sixty-five study subjects were divided into healthy subjects (24 subjects) and patients with dengue infection (41 subjects). There were no significant differences in hemoglobin (Hb) and hematocrit (Hct) values between the groups, but differences were found in the number of leukocytes, absolute number of monocytes and platelet count (p<0.001, 0.002 and <0.001, respectively). The mean expression of FcγIIR monocytes in patients with dengue infection (208.77±32.06 median fluorescent intensity (MFI)) and the healthy subjects (124.03±47.76 MFI) with p<0.0001.

Conclusions

The mean expression of FcγIIR monocytes in patients with dengue infection was higher than in healthy subjects.

Background

Dengue haemorrhagic fever (DHF) is still a problem in Indonesia. It is a syndrome that in most severe form may threaten the patient’s life, primarily through increased vascular permeability due to endothelial dysfunction leading to shock. Von Willebrand factor (vWf) is a blood glycoprotein involved in haemostasis and present in the blood plasma. The vWf is reported as one of dysfunction endothelial marker. However, there is limited information about the kinetics and contribution of vWf in the pathogenesis of DHF in adult patients.

Methods

In this study, a serial level of vWf was measured as kinetic of plasma vWf. It is expected that, the evidence based medicine will give contribution in the management of DHF patients. Also, in the future a study will be conducted especially about the prediction of shock to know the kinetic of plasma von Willebrand factor in adult dengue haemorrhagic fever patients. A cross-sectional repeated–measurement study was conducted from October 2007 up to January 2008 in the Department of Clinical Pathology at the Sardjito General Hospital Yogyakarta. Subjects who met the eligible criteria were selected i.e. adult patients hospitalized in the Department of Internal Medicine diagnosed as DHF based on WHO criteria and antibody anti-dengue detection. Serial measurement of plasma vWf was determined on days five (5), seven (7) and 15 using enzyme linked fluorescent assay (ELFA) principle.

Results

The resulting data was shown graphically and the difference in levels of vWf among the three groups of time was analyzed by Friedman’s test. The study results showed an increase of vWf on day five /5 (218.48 %), followed by 187.08 % on day seven (7). Interestingly, there was a sharp increase of vWf on day 15 (233.80 %). In addition, there were statistically significant different levels of vWf among those three groups (p = 0.00) in adult dengue haemorrhagic fever patients with the von Willebrand kinetic factor showing a fluctuation pattern. There is an increased level of vWf on the fifth (5) day but a decrease on the seventh (7) day. However, there is a sharp increase in the convalescence phase.

Conclusions

Background

Hand hygiene is a noncomplex and a cost-effective way to prevent hospital-acquired infection (HAI). The incidence of hospital acquired MRSA (HA-MRSA) cross-infection is an indicator directly measure the hand hygiene practice at the point of care. Objective: Our study aimed to evaluate the impact of hand hygiene compliance on HA-MRSA cross transmission in the intensive tertiary care of Dr. Sardjito General Hospital, Gadjah Mada University teaching hospital, Yogyakarta, Indonesia.

Methods

A quasi-experimental before-after design was conducted to evaluate the implementation of the WHO multimodal hand hygiene improvement strategy which was adjusted to the local needs, based on the qualitative study result from the intensive care from June 2014 to April 2016. All workers who have frequent contact with patients were observed for their hand hygiene compliance by trained observers. The incidence of HA-MRSA was recorded through active surveillance accompanied by microbiology data.

Results

There were 92 healthcare workers (18 medical doctors, 45 nurses, 29 other staffs) and 5,280 patients involved throughout the study period. There were 16,313 hand hygiene opportunity observations which resulted in a significantly improved practical accuracy-consistency-sustainability, after intervention in the initial and end-evaluations. There was a significant decrease in the HA-MRSA rate from 12.6% before intervention to 1.2% and 0.3% at the initial and end-evaluations, respectively.

Conclusion

Background

Safe blood was collected from safe, low risk donors with a related absence of infectious disease screening as well. WHO has stated
that to guarantee its safety, blood should only be collected from voluntary non-remunerated blood donors (VNBD) coming from a low risk population. The aim of this study was to know the blood donors’ profile in Fatmawati Hospital (FH), Jakarta and Dr. Sardjito Hospital (SH), Yogyakarta by comparison.

Methods

The research design was cross sectional. The subjects were women in term pregnancy, gathered from PKU Muhammadiyah Hospital, Bantul Yogyakarta from May to November 2013. A seven (7) mL blood sample was taken from the cubital vein of the subjects. Two mL of the sample was tested for routine hematological examination using an EDTA tube, while the Ret-He was assessed using an automatic hematological instrument Sysmex XT-2000-i (Symex Corporation, Kobe, Japan). The serum
of the remaining five (5) mL was used to check the serum iron and TIBC to obtain the saturation value (Tsat) using Cobas analyzer C501 (Roche Diagnostics, Germany), while the serum ferritin (SF) was examined using Minividas. The subjects were classified into two (2) groups based on the Hb levels, namely: anemia (Hb<11 g/dL) and those who did not (Hb≥11 g/dL). Furthermore, they were also classified into two (2) groups based on transferrin saturation values: iron deficient (Tsat <9%) and normal (Tsat ≥9%).

Results

Conclusions

There was an increased VNBD percentage i.e. 32, 35, 54 (FH) and 12, 18, 22 (SH) respectively, within the year 2011, 2012 and 2013.

Background

Patients with End-Stage Renal Disease (ESRD) tend to have immune imbalance triggered by uremia and Hemodialysis (HD) procedures. Contact between dialysis membrane and blood will cause bio-incompatibility reactions inducing complement activation and production of Reactive Oxygen Species (ROS) as well as proinflammatory cytokines and acute phase protein such as C-Reactive Protein (CRP). Those immune response imbalances will lead to an immunocompromised condition. The objective of this study was to prove the correlation between inflammatory markers (IL-1β, IL-6 and C-reactive proteins) and its anti-inflammatory marker (IL-10) in routine hemodialyzed patients.

Methods

This is a cross-sectional observational study involving 90 subjects conducted at the Hemodialysis Installation of the Dr. Sardjito Hospital. The inclusion criteria of this study were patients who underwent routine HD procedures, aged between 18 and 65 years-old, having leukocytes count and albumin level within normal limit. The exclusion criteria of this study were patients with Acute Coronary Syndrome (ACS) and malignancies. Levels of IL-1β, IL-6 and IL-10 were measured using Enzyme-Linked Immunosorbent Assay (ELISA), while CRP was measured using highly-sensitive CRP immunoturbidimetry. Statistical analysis was performed by Spearman test.

Results

Conclusions

This study showed that there were correlations between pro-inflammatory and anti-inflammatory cytokines. Further studies of polymorphism-related cytokines secretion are warranted.