This study aims to analyze the ratio of the number of microorganism colonies on the surface of medical personnel’s hands before and after the use of three types of alcohol-based handrubs. This study is an experimental study with pre and post design at Dr. Soetomo Hospital in September-October 2019 with 20 respondents for each handrub used. T-test was performed to analyze the number of microbe colonies before and after the use of handrub with the combination of chlorhexidine gluconate, meanwhile Wilcoxon test was performed to analyze the number of microbe colonies before and after the use of handrub with the combination of n-propanol and hydrogen peroxide. Effectiveness analysis of the three handrubs was done using Kruskal Wallis test. There was a significant difference in the number of microbes before and after the use of handrub (p <0.05). The lowest median value of the number of microbes after the use of an alcohol-based handrub was found in the handrub with the combination of chlorhexidine gluconate, with 96.25%, followed by hydrogen peroxide with percentage of 95.25% and n-propanol with percentage of 92%. There was no significant difference in the number of microbial colonies after the use of the three handrubs (p >0.05). Hands are an intermediary medium that often transmit pathogenic microorganisms that may cause HAIs. According to WHO, the usage of the three types of alcohol-based handrubs in this research can significantly decrease the number of germs. In conclusion, there was a significant difference in the number of microbial colonies before and after handrub usage. Alcohol-based handrub with the combination of chlorhexidine gluconate had the greatest effect on decreasing microbial colony count in this study. The contents of the three types of handrubs studied in this research were equally effective in decreasing microbial colony numbers on the hands of health workers.

Backgroud: Chronic Myeloid Leukaemia (CML) is a clonal hematopoiesis stem cell disorder, characterised by reciprocal translocation between chromosomes 9 and chromosomes 22, originally named the 'Philadelphia chromosome'(Ph). The megakaryoblastic transformation of a CML is extremely rare, consisting <3% of transformed cases. Case Description: A 68-year-old male presented with a CML history since 2000 and received Imatinib therapy. The patient currently showed anemia and splenomegaly. Laboratory results showed hemoglobin 8.1 g/dL, leukocyte count 31,740/ L, platelet count 7,000/ L, Immature Platelet Fraction (IPF) 29.2%, BCR-ABL gene fusion is positive. Bone marrow examination showed CML blastic crisis phase with 45% blasts which had megakaryoblast morphology so it was concluded as a CML that underwent a transformation into megakaryoblastic. The results of bone marrow aspirate using Sysmex-XN1000 showed a very high IPF value which indicated an increased megakaryopoietic proliferative activity. Immunophenotyping examination showed blast population with CD45 dim, low side scatter, with the expression of CD34+, CD33+, CD13+ corresponding to the megakaryoblast area. Examination of the CD41 and CD61 specific megakaryoblast markers was not performed due to reagent limitations. Conclusion:A CML patient has been reported with suspected megakaryoblastic transformation based on the bone marrow morphology, immunophenotyping, molecular and elevated IPF examination.