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Introduction: COVID 19 was a disease caused by the SARS-CoV 2 virus with severe respiratory distress syndrome. SARS-CoV 2 can attack the gastrointestinal and liver system. In several studies, elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were reported, ranging from 14% to 53%. The increase of neutrophil to lymphocyte ratio (NLR) also increases the risk of mortality in COVID 19. This research wants to study ALT, AST, and NLR as prognostic and predictor in COVID 19. Methods: A cross sectional retrospective study conducted on COVID 19 patients. The diagnostic criteria are based on the recommendations of the Indonesian Ministry of Health. The patient's blood was examined in a central laboratory at hospital. Data analysis were done using SPSS version 22.  Results: A total of 126 patients with COVID 19 were included in this study. There are 57 (45.2%) patients having abnormal liver test. There was a significant difference in the mean AST and NLR between COVID 19 patients with nonsurvival and survive outcome (82.91 ± 103.82 vs. 40.54 ± 33.59 U/L; p = 0.0001 and 7.42 ± 3.65 vs. 3.47 ± 2.41; p = 0.0001). High AST (≥34.5 U/L) and NLR (≥4.7) independently associated with nonsurvival outcome in COVID 19 patient with odds ratio (OR) 5.31 and 9.49 [1.89 – 14.95, 95% CI; p = 0.002 and 3.57 – 25.22, 95% CI; p = 0.0001]. Conclusion: This study revealed that high AST and NLR at hospital admission was associated with high mortality risk in COVID 19 patients. Therefore, the AST and NLR can be a significant prognostic of outcome in COVID 19 patients.

: Hypertension is chrocnic medical condition which the blood pressure has elevated above 140mmHg systolic and 90 mmHg diastolic. Hypertension is one of top 10 of the causes of death worldwide. It is because hypertension affects in damaged of some organs like heart, brain, renal, retinal, ect.The purpose of this study is to give the information about profile of hypertensive patients and about antihypertensive drugs which most commonly used in Prof. Dr. R. D. Kandou General Hospital Manado.This is descriptive retrospective study. The data had been taken from medical records in Nephrology and Hypertension Clinic at Prof. Dr. R. D. Kandou General Hospital Manado.Keywords : Hypertension, Complication, Antihypertensive drugsAbstrak : Hipertensi merupakan kondisi dimana tekanan darah sistol diatas 140 mmHg dan tekanan darah diastol diatas 90 mmHg.Hipertensi menjadi salah satu penyebab kematian terbanyak didunia karena hipertensi dapat mempengaruhi kerusakan pada organ-organ target yang lain seperti organ jantung, otak, ginjal, mata dan lain-lain.Tujuan penelitian ini untuk memberikan gambaran tentang profil pasien hipertensi serta jenis obat antihipertensi yang digunakan di poliklinik ginjal-hipertensi RSUP Prof. Dr. R. D. Kandou Manado periode Oktober 2014 - Maret 2015.Penelitian ini merupakan jenis penelitian deskriptif retrospektif dengan data sekunder di poliklinik ginjal-hipertensi RSUP. Prof. Dr. R. D. Kandou Manado periode Oktober 2014 - Maret 2015. Sampel penelitian sebanyak 311 pasien.Kata Kunci : Hipertensi, Komplikasi, Obat Antihipertensi

Indonesia still ranks as the third country in the world to have the most cases of tuberculosis (TB). For this reason, there is a needed treatment for TB, called the Anti-Tuberculosis Drugs (ATD) which comprises of isoniazid, ethambutol, pyrazinamide, rifampicin and streptomycin and this should be taken for 6-8 months. However, ATD has side effects mainly in disturbing the liver function that can be assessed by the serum levels checkup of SGOT, SGPT and bilirubin. This study aimed to determine the level of bilirubin pulmonary TB of patients during the treatment in RSUP Prof. DR. R.D. Kandou Manado for the period of January 2012 to December 2014. This was an observational descriptive study with a cross sectional design by using the medical records of patients of pulmonary TB hospitalization for the period of January 2012 to December 2014. There were 32 patients as samples. There has been an increase in total bilirubin levels during the ATD treatment. It has been discovered that as big as (47%) had an increase level of total bilirubin. The total of bilirubin levels had increased more in male patients. The increase in the total bilirubin occurred in the age of >35 and the more it increases with age. Meanwhile, the increase in direct bilirubin levels had been found in as many as (56%). The indirect bilirubin levels had been found to be normal in (91%). A total of (31%), with hyperbilirubinemia, had not had comorbidities and most had often occurred in the first month of ATD treatment.Keywords: pulmonary tuberculosis, bilirubin, antituberculosis drug, hepatotoxicityAbstrak: Indonesia masih menempati urutan ketiga negara penderita tuberkulosis (TB) terbanyak didunia. Untuk itulah, dibutuhkan pengobatan TB, yang dinamakan Obat Anti Tuberkulosis (OAT) yang terdiri isoniazid, etambutol, pirazinamid, rifampicin dan streptomisin yang harus dikonsumsi selama 6-8 bulan. Akan tetapi, OAT memiliki efek samping terutama menggangu fungsi hati yang dapat dinilai melalui pemeriksaan kadar serum SGOT, SGPT dan bilirubin. Untuk mengetahui kadar bilirubin pasien TB Paru selama pengobatan di RSUP Prof DR. R.D. Kandou Manado periode Januari 2012-Desember 2014. Desain penelitian yang digunakan adalah penelitian observasional deskriptif dengan pendekatan potong lintang (cross sectional) dengan memanfaatkan rekam medik pasien TB Paru rawat inap periode Januari 2012-Desember 2014. Jumlah sampel yang terpakai sebanyak 32 orang. Terjadi peningkatan kadar bilirubin total selama pengobatan OAT. Ditemukan sebesar (47%) terjadi peningkatan kadar bilirubin total. Kadar bilirubin total meningkat lebih banyak pada pasien laki-laki. Peningkatan bilirubin total terjadi pada usia >35 tahun dan semakin meningkat seiring bertambahnya usia. Sedangkan, kadar bilirubin direk ditemukan sebanyak (56%) terjadi peningkatan kadar bilirubin direk. Kadar bilirubin indirek ditemukan normal pada (91%). Sebanyak (31%) yang menderita hiperbilirubinemia tidak memiliki penyakit penyerta dan paling sering terjadi pada satu bulan pertama pengobatan OAT.Kata kunci: tuberkulosis paru, bilirubin, obat antituberkulosis, hepatotoksitas

The World Health Organization have declared COVID-19 as a pandemic. The COVID-19, caused by SARS-CoV-2, is spreading at an alarming rate and creates a significant worldwide burden to the economy while increasing morbidity and mortality. While COVID-19 was primarily considered as a respiratory-infection disease, several reports have shown that many COVID-19 infected patients have presented or developed some digestive symptoms. Many studies also demonstrated, using reverse transcriptase-polymerase chain reaction method, that SARS-CoV-2 are present in stools or other gastrointestinal tract secretions. All these reports raised the possibility of COVID-19 transmission via the fecal-oral route and the involvement of the gastrointestinal-liver system. Until further studies are available, physicians should be aware of the digestive manifestation of COVID-19 and use universal precautions to avoid the transmission of COVID-19 via the fecal-oral route.