Background: Constipation is common and affects 15% of population worldwide. Constipation can decrease the quality of life of the patients and may be affected by many factors, including stress. Stress too, is general, especially in students, causing higher rates in suicidal tendency and impairments from various aspects. Today, in COVID-19 pandemic, stress is more common due to numerous causes. One of the causes is online studying in COVID-19 pandemic, which might trigger stress in students. Objectives: To determine the relationship between online study stress in COVID-19 pandemic with constipation in the year 2018 medical students of USU in 2021. Method: This study is an analytical observational study using a cross-sectional design. Samples in this study were 112-year 2018 medical students of USU who satisfied the inclusion criteria and gathered by using a consecutive sampling method. Primary data were acquired by using an online- shared questionnaire in the google form and submitted by the respondents. Then, univariate, and bivariate analyses were performed on the data using SPSS, with the latter using fisher’s exact test. Results: In this study, 78 students (69,6%) were stressed and 8 students (7,1%) were constipated. The analysis between the two variables using fisher’s exact test shown the p value about 0,431, which can be interpreted as no association found between online study stress in COVID-19 pandemic with constipation. Conclusion: Online study stress in COVID-19 pandemic is not associated with constipation.   Keywords: Constipation, Pandemic, Online study, Stress

Pendahuluan: Apendisitis akut merupakan salah satu penyebab operasi gawat darurat dalam bidang gastroenterohepatologi. Hanya apendisitis yang terkomplikasi seperti perforasi yang memerlukan tindakan operasi. Saat ini belum ditemukan cara untuk menegakkan apakah pasien apendisitis yang datang perlu dilakukan operasi atau hanya dengan terapi konservatif dengan antibiotik. Salah satu pemeriksaan yang dapat dikaitkan pada apendisitis adalah Matriks Metalloproteinase (MMP). Tinjauan pustaka ini bertujuan untuk mengetahui potensi dan sensitivitas MMP sebagai biomarker untuk menentukan kemungkinan terjadinya perforasi pada apendisitis akut. Metode: Artikel dibuat dengan metode literature review dengan menggunakan textbook dan 21 jurnal, dengan 10 jurnal utama. Jurnal diperoleh dari search engine Pubmed, Cochrane, dan Google Scholar.  Pembahasan: MMP memiliki sifat proteolitik terhadap matriks ekstraseluler pada jaringan ikat yang meningkat pada reaksi inflamasi. Ketidakseimbangan MMP terhadap Tissue Inhibitor of Metalloproteinase (TIMP) pada apendisitis menyebabkan peningkatan aktvitias proteolisis yang merusak dinding apendiks yang menjadi patofisiologi perforasi. Ekspresi dan konsentrasi MMP dijumpai meningkat secara signifikan pada pemeriksaan biopsi, imunohistokimia, cairan peritoneum, dan serum pasien yang mengalami komplikasi apendisitis dibandingkan dengan apendisitis tanpa komplikasi. MMP mampu membedakan apendisitis terkomplikasi dengan tidak, namun membutuhkan pemeriksaan TIMP untuk menentukan jenis komplikasi apendisitis. Simpulan: Pemeriksaan MMP dan TIMP berpotensi menjadi biomarker terjadinya perforasi pada apendisitis. Saran: Diperlukan penelitian lebih lanjut untuk menentukan nilai cut-off pada apendisitis.

ABSTRACT Introduction: Chronic Kidney Disease (CKD) is a common disease that is still being a public health problem, especially in the elderly, as a result of cardiovascular complication which is the most important cause of death among the elderly in developing countries. This literature review aims to comprehend the diagnostic accuracy of urinary NGAL in CKD. This literature review is made by doing literature searching on search engines such as Google Scholar, PubMed, and Sciencedirect, with utilizing NGAL, uNGAL, biomarker, CKD, and elderly as the keywords. From the process, 37 journals were obtained and used as this literature review references. Discussions: By analyzing the literatures, it is known that NGAL is a polypeptide that belongs to the lipocalin family, where the expression will increase in inflammations, including in the kidneys. In diagnosis of CKD, the diagnostic ability of urinary NGAL shown by AUC values were higher than the other biomarkers. In addition, urinary NGAL has a stronger correlation with the deterioration of kidney function, compared to that of plasma NGAL. Conclusion: In conclusion, urinary NGAL is a potential urinary biomarker in diagnosing CKD in the elderly. Keywords: Biomarker, CKD, NGAL, Urine

<p class="AbstractNormal"><strong>Introduction: </strong>Lung cancer is one the deadliest cancer known. Current method using low-dose CT scan to screen lung cancer applied are proved to reduce mortality, but lack in accuracy leading to overdiagnosis. Current researches are mostly seeking for a non-invasive and cost-effective method, hence biomarkers such as microRNA has a potency to screen and diagnose lung cancer. This literature review aimed to discuss the potency of microRNA in sputum as a biomarker in screening lung cancer.</p><p class="AbstractNormal"><strong>Methods:</strong><strong> </strong>The study is conducted by literature searching for related journals in search engines such as PubMed, Science Direct, and Google Scholar with keywords. 35 articles were included with relevance and within 10 years publication.</p><p class="AbstractNormal"><strong>Result:</strong><strong> </strong>MicroRNA is a short non-coding RNA which regulates gene expression. It acts in an oncogene or tumor suppressor gene regulation. DNA mutations or defects occurred in cancer particularly in lung cancer causes increase or decrease of microRNA expression. Alterations of microRNA expression in sputum detected by rt-PCR may represent progressions of lung cancer from a cell cycle dysregulation and provides better sensitivity and specificity among other biomarkers. Combinations of miRNA species offer increase of  sensitivity and specificity. Particular types of microRNA are able to classify the types of lung cancer in progress.</p><p><strong>Conclusion: </strong>MicroRNA has the promising potency and strong accuracy with a non-invasive and cost-effective procedure in detecting early signs of lung cancer occurrence and can be further applied as biomarker used in lung cancer.</p><p>Keywords: Biomarker; Lung Cancer; microRNA; Screening; Sputum</p>