Jourdan Wirasugianto

Objectives: This study aims to describe the ultrasound findings and biomarker profiles (CA-125, HE4, CEA, ADA, and IGRA) in confirmed cases of peritoneal tuberculosis (PTB) and to discuss their relevance in clinical evaluation. Methods: This is a retrospective study utilizing data from 12 female subjects with a confirmed PTB diagnosis at Cipto Mangunkusumo Hospital and Hermina Depok Hospital between 2018 and 2023. Data were extracted from medical records. Biomarker levels were measured using standardized assays in a single accredited laboratory. Ultrasonography was performed using the Mindray Resona 7 system. Results: The mean age was 33.0 ± 9.7 years. Ultrasonography identified significant features of PTB, such as hydrosalpinx 7 (58.3%), adhesions 6 (50%), ascites 7 (58.3%), cystic/mass-like lesions 4 (33.3%), and involvement of the rectosigmoid colon and small bowel 2 (16.6%). CA-125 levels were elevated (mean: 484.25 U/mL), and HE4 was high in 41.6% of cases (mean: 66.8 pmol/L). CEA levels remained low (mean: 1.725 ng/mL), and ADA levels were elevated in all patients (mean: 45.8 U/L). IGRA testing yielded a 75% positivity rate, with one patient converting from negative to positive after a month. Conclusions: Ultrasound remains a valuable imaging modality for identifying characteristic features of PTB, particularly hydrosalpinx and ascites. Elevated CA-125 and ADA, alongside IGRA results, may support clinical suspicion and help guide diagnosis in settings where invasive procedures are limited.

Cervical cancer is the fourth most prevalent cancer among women globally. Protein concentrations of Large Tumor Suppressor Kinase-1 (LATS1) and Nuclear Factor Kappa-B (NF-κB) have been identified as prospective biomarkers of radioresistance in cervical cancer. This preliminary study aimed to investigate the effectiveness of LATS1 and NF-κB levels as a biomarker for radioresistance and evaluate their response to radiation in cervical cancer patients. A comprehensive cross-sectional study was conducted involving 114 subjects diagnosed with advanced stages cervical cancer (stage IIIB and IVA) who underwent definitive radiotherapy. The concentrations of LATS1 and NF-κB were measured using ELISA from biopsy samples taken prior to the initiation of radiotherapy. This study’s finding included 114 subjects, with a median age of 53 years. A total of 85 (74.5%) subjects had stage IIIB, while 29 (25.4%) subjects had stage IVA. The cut-offs for LATS1 and NF-κB were 0.02765 ng/mg and 192.42 pg/mg, respectively. Subjects with a higher expression of LATS1 were found to be unresponsive to radiation therapy (p ≤ 0.001; AUC = 32.7%), and subjects with a lower expression of NF-κB were found to be unresponsive to radiation therapy (p = 0.009; AUC = 61%). This study suggests that elevated LATS1 expression may inversely predict radioresistance, while NF-κB expression shows a weak correlation with resistance to radiation therapy.

Radioresistance poses a significant challenge in the effective treatment of cervical cancer, often leading to poor patient outcomes. MicroRNA-21 (miR-21) and MicroRNA-145 (miR-145) are oncogenic micro-RNAs associated with various cancers, including cervical cancer, but their potential as predictive biomarkers for radioresistance remains underexplored. This study aimed to investigate the association between miR-21 and miR-145 expressions and the response to radiation therapy in cervical cancer patients. An analytical cross-sectional study was conducted on 140 subjects with cervical cancer stages IIIB and IVA who received definitive radiotherapy. miR-21 and miR-145 expressions were measured using real-time reverse transcriptase–polymerase chain reaction (RT-qPCR). A total of 102 subjects (72.9%) were classified as having stage III cervical cancer, and 38 subjects (27.1%) were classified as having stage IV cervical cancer. Disease progression occurred in 60.7% of subjects. The cut-off value for miR-21 expression was 0.00088 nmol/(mg/mL) (AUC 0.676, sensitivity 70.8%, specificity 50.8%), and a higher expression was significantly associated with radioresistance (p = 0.010). miR-145, with a cut-off of 0.0239 nmol/(mg/mL) (AUC 0.612, sensitivity 67.5%, specificity 45.5%), showed no significant association with treatment response (p = 0.132). Combining miR-21 and miR-145 (AUC 0.639, sensitivity 68.6%, specificity 46.9%, p = 0.063) did not significantly improve the predictive accuracy. This study suggests that an elevated miR-21 expression is significantly associated with radioresistance in cervical cancer patients, while miR-145 expression shows no significant correlation with treatment response. Additionally, combining miR-21 and miR-145 does not enhance the predictive power.

Introduction: Hyperglycemic crisis caused by an increase of insulin requirement and one of the predisposing factors are cardiovascular disease; this condition can induce an increasing cytokine which also acts as a coronary heart disease marker. The latest study remains unclear about the association with cardiovascular outcomes. This study aimed to investigate the association between hyperglycemic crisis and major adverse cardiovascular events (MACEs). Materials and methods: This study is an analytical study with cohort retrospective design conducted at Sanglah General Hospital from February until April 2019. The data was taken using the total sampling method; 126 samples were collected from the medical record with 43 samples hyperglycemic crisis as a case group and non-hyperglycemic crisis as a control group with 83 samples according to inclusion and exclusion criteria — the analysis using univariate and bivariate survival analysis. The primary outcome was the risk ratio. Results: The median age in this study was 45.69 years old (SD 2.53) for the case group and control 55.73 ± 1.21 years old. The gender ratio between males and females in both groups is 1:1–2; the mean of HbA1c in the case group is higher than the control group, 12.06 ± 3.06 vs. 7.9 (5.1–14.8) %. Relative risk analysis between hyperglycemic crisis and MACE is obtained RR 5.576 with 95% CI: 2.87–10.8 and p-value = 0.000 with potential confounding variable are not associated. Conclusions: There is a significant association between hyperglycemic crisis and MACE statistically. Introduction: Hyperglycemic crisis caused by an increase of insulin requirement and one of the predisposing factors are cardiovascular disease; this condition can induce an increasing cytokine which also acts as a coronary heart disease marker. The latest study remains unclear about the association with cardiovascular outcomes. This study aimed to investigate the association between hyperglycemic crisis and major adverse cardiovascular events (MACEs). Materials and methods: This study is an analytical study with cohort retrospective design conducted at Sanglah General Hospital from February until April 2019. The data was taken using the total sampling method; 126 samples were collected from the medical record with 43 samples hyperglycemic crisis as a case group and non-hyperglycemic crisis as a control group with 83 samples according to inclusion and exclusion criteria — the analysis using univariate and bivariate survival analysis. The primary outcome was the risk ratio. Results: The median age in this study was 45.69 years old (SD 2.53) for the case group and control 55.73 ± 1.21 years old. The gender ratio between males and females in both groups is 1:1–2; the mean of HbA1c in the case group is higher than the control group, 12.06 ± 3.06 vs. 7.9 (5.1–14.8) %. Relative risk analysis between hyperglycemic crisis and MACE is obtained RR 5.576 with 95% CI: 2.87–10.8 and p-value = 0.000 with potential confounding variable are not associated. Conclusions: There is a significant association between hyperglycemic crisis and MACE statistically.

Gangguan bipolar merupakan gangguan kronis berulang ditandai dengan munculnya fluktuasi keadaan mood dan energi. Gangguan bipolar adalah salah satu penyebab kecacatan di kalangan anak muda, yang menyebabkan gangguan kognitif dan fungsional. Berdasarkan data Riskesdas pada tahun 2013, prevalensi gangguan mental emosional yang ditandai dengan adanya gejala depresi serta kecemasan usia 15 tahun ke atas mencapai sekitar 6% dari jumlah penduduk di Indonesia. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik pasien gangguan bipolar di RSUP Sanglah Denpasar, Bali. Penelitian dilakukan dengan metode deskriptif studi potong lintang. Sampel dipilih dari populasi berdasarkan kriteria inklusi dan eksklusi. Analisis data menggunakan software SPSS 25.0 untuk mendapatkan karakteristik gangguan bipolar. Hasil penelitian menunjukkan range usia 57 tahun dengan mean yaitu 32,75 tahun serta didominasi oleh jenis kelamin perempuan (53,5%). Pekerjaan sebagai pegawai swasta terbanyak ditemukan sebesar 56,3%. Sekolah Menengah Atas merupakan pendidikan terakhir yang paling banyak ditemukan dengan persentase 47,9% dan sebagian besar pasien berada dalam status belum menikah (76,1%). Tipe gangguan bipolar F31.2 mayoritas ditemukan yaitu sebanyak 45,1% dan pasien rawat inap dengan kunjungan pertama Kata Kunci: Gangguan Bipolar, Karakteristik, Klasifikasi

Background: Diabetic nephropathy (DN) is caused by chronic complications due to microvascular changes in patients with T2DM associated with the inflammatory process. Neutrophils to Lymphocyte Ratio (NLR) is a ratio that can describe the acute and chronic inflammatory systemic and allegedly the inflammatory process in the kidney. This study aims to determine the association between NLR with diabetic nephropathy in patients with type 2 diabetes. Method: This study is an analytical study with a case-control design. Samples were taken from the medical record installation room at Sanglah General Hospital Denpasar. Data was taken by using a simple random sampling method for 1 year that is 2017 according to inclusion and exclusion criteria. Statistical analysis including univariate analysis, normality test, Mann Whitney test, chi-square test, and AUC was done by using SPSS 23. Results: 143 sample data were used in this study with an average age of 62 years old (S.D 11.5). Median NLR for DN as case group were found 3.19 ranges within 1.19-29.2 while median NLR for non-DN as control group were found 3.2 (0.82-15.5) with p=0.000. NLR proportion ≥2.5 in the non-DN group was found 30 (42.2%) and DN group were found 49 (68%) with p=0.002. Risk analysis between NLR and Diabetic nephropathy obtained OR 2.91 and 95% CI: 1.45 - 5.76. Other variables such as age, sex, and diabetic status towards NLR levels were found not statistically significant. The results of AUC were 69.6% with 95%CI within the range (61.1% -78.2%). Conclusion: There is a significant association between NLR and diabetic nephropathy which potentially reflects the inflammation of the diabetic nephropathy process.