Introduction. Acute Coronary Syndrome (ACS) is a cardiovascular disease that has a high mortality rate. One of the markers which play a role in the pathophysiology of ACS is Immunoglobulin E (Ig E), one of the antibodies released by B lymphocytes as the result of complex interactions that can activate mast cells. Mast cells will activate Metalloproteinase-9 (MMP-9) then facilitate pathogenesis of acute myocardial infarction or acute coronary syndrome phase. This study aimed to determine the relationship between increasing levels of IgE and MMP-9 in ACS patients at Sanglah Hospital, Denpasar, Bali.Method. This was a cross-sectional analytic study, and the samples were collected from ACS patients at Sanglah Hospital, Denpasar, Bali, using a consecutive sampling method. A total of 73 samples were included in this study, then statistical tests and Pearson correlation test was conducted.Results. Seventy-three samples included in this study contain 59 men (80.8%) and 14 women (19.2%). The IgE level is between 0.5-1000 and MMP-9 levels between 6.91-29.56. There is a statistically significant correlation between IgE levels and MMP-9 levels in Acute Coronary Syndrome patients (p = 0.018: r = 0.277).Conclusion. We found a significant association between increased IgE and MMP-9 in patients with Acute Coronary Syndrome at RSUP Sanglah, Denpasar, Bali. Pendahuluan. Sindrom Koroner Akut (SKA) merupakan penyakit kardiovaskular dengan angka kematian yang sangat tinggi. Salah satu marker yang berperan dalam patofisiologi SKA adalah Immunoglobulin E (IgE). IgE merupakan salah satu antibodi yang dilepaskan oleh limfosit B sebagai interaksi kompleks yang dapat mengaktivasi sel mast. Sel mast yang sudah aktif akan mengaktivasi Metallopriteinase-9 (MMP-9) yang ikut berperan dalam patogenesis miokard infark akut atau sindrom koroner akut. Penelitian ini bertujuan unuk mengetahui hubungan peningkatan kadar IgE dan MMP-9 pasien SKA di RSUP Sanglah, Denpasar, Bali.Metode. Penelitian ini merupakan penelitian potong lintang analitik yang dilakukan pada populasi SKA di RSUP Sanglah, Denpasar, Bali. Sampel keseluruhan berjumlah 73 orang pasien SKA secara konsekutif diikutsertakan dalam penelitian ini, kemudian dilakukan uji statistik dan uji korelasi Pearson.Hasil. Dari hasil penelitian pada 73 sampel tersebut, didapatkan jumlah sampel 59 orang laki-laki (80,8%) dan 14 orang perempuan (19,2%). Adapun kadar IgE dalam rentang antara 0,5-1000 dan kadar MMP-9 antara 6,91-29,56. Terdapat korelasi yang bermakna antara kadar IgE dengan kadar MMP-9 pada pasien Sindrom Koroner Akut (p=0,018; r=0,277).Kesimpulan. Terdapat hubungan yang signifikan antara peningkatan kadar IgE dengan peningkatan kadar MMP-9 pada pasien Sindrom Koroner Akut di RSUP Sanglah, Denpasar, Bali.

Background: Since March 2020, Coronavirus Disease 2019 (COVID-19) has been declared a pandemic. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) underwent genetic evolution and changes in the nature of the virus, clinical manifestations, and response to treatment. This study aims to determine the profile of hospitalized COVID-19 patients at  Ari Canti Hospital (RSAC), one of the COVID-19 referral hospitals in Gianyar, Bali. Methods: The design was a descriptive cross-sectional retrospective study, using the medical records of confirmed COVID-19 by Real Time Polymerase Chain Reaction (RT-PCR) patients selected by a simple random sampling technique. Results: From 290 samples, the majority of COVID-19 patients treated at RSAC were 60.7% male, in the age range of 50-59 years 26.5%, with severe symptoms 45.8% and recovered 83.4%. The dominant symptoms were fever 85.2%, cough 80%, and shortness of breath 60%. The most common comorbidities were >1 comorbidity, hypertension, and diabetes mellitus. Hematological examination at the first time of hospitalization showed leukopenia (4.8%), lymphopenia (14.5%), thrombocytopenia (12.8%),  and anemia (21.7%). The results also showed an increase in Neutrophil to Lymphocyte ratio (NLR) (31.4%), Platelet to lymphocyte ratio (PLR) (11.7%), Red Cell Distribution Width (RDW) (40.7%), D-Dimer  (73.4% ) dan High sensivity C-Reactive Protein (Hs-CRP)  (66.6%). Most showed bilateral infiltrates on chest x-ray. The most common treatment for COVID-19 at RSAC uses antiviral remdesivir (77.9%), quinolone antibiotics (73.4%), and Low Molecular Weight Heparin (LMWH) (53.4%).  A total of 56.6% of patients received corticosteroid therapy. Conclusion: Patients hospitalized at RSAC mostly showed severe symptoms and recovered. The treament folowing the standard of inpatient treatment for COVID-19 patients.   Latar belakang: Sejak Maret 2020, Coronavirus Disease 2019 (COVID 19) dinyatakan sebagai pandemi. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) mengalami evolusi genetik dan perubahan sifat virus, manifestasi klinis serta respon pengobatan. Penelitian ini bertujuan untuk mengetahui profil pasien COVID-19 yang dirawat di Rumah Sakit Ari Canti (RSAC), salah satu rumah sakit rujukan COVID-19 di Gianyar, Bali Metode: Rancangan penelitian ini adalah cross-sectional deskriptif retrospektif, menggunakan rekam medis pasien terkonfirmasi COVID-19 dengan Real Time Polymerase Chain Reaction (RT-PCR) sejak Juli 2020 - Maret 2022 yang dipilih dengan teknik simple random sampling. Hasil: Dari 290 sampel, mayoritas pasien COVID-19 yang dirawat di RSAC adalah laki-laki 60.7%, berada pada rentang usia 50-59 tahun 26.5%, dengan gejala berat 45.8% dan sembuh 83.4%. Gejala didominasi demam 85.2%, batuk 80%, dan sesak 60%. Komorbid tersering yaitu >1 komorbid, hipertensi, dan diabetes melitus. Gambaran hematologi menunjukkan leukopenia (4.8%), limfopenia (14.5%), trombositopenia (12.8%), dan  anemia (21.7%). Hasil juga menunjukkan peningkatan Neutrophil to Lymphocyte ratio (NLR) (31.4%), Platelet to lymphocyte ratio (PLR) (11.7%), Red Cell Distribution Width (RDW) (40.7%), D-Dimer (73.4% ) dan High sensivity C-Reactive Protein (Hs-CRP) (66.6%). Sebagian besar menunjukkan infiltrat bilateral pada x-ray thorax. Tatalaksana COVID-19 di RSAC tersering menggunakan antivirus remdesivir (77.9%), antibiotik golongan kuinolon (73.4%), dan antikoagulan Low Molecule Weight Heparin (LMWH) (53.4%). Sebanyak 56.6 % pasien mendapat terapi kortikosteroid. Kesimpulan: Pasien COVID-19 yang dirawat di RSAC sebagian besar menunjukkan gejala berat dan sembuh. Terapi yang diberikan mengikuti standar terapi rawat inap pasien COVID-19.

Stevens-Johnson syndrome (SJS) is a cutaneous immunity reaction involving the skin and mucosa and is an emergency condition that can be fatal. The incidence of this disease is relatively rare in the range of 1-2 per 1.000.000 population. The pathogenesis of SJS involves the immune system response of antigenic drug to body tissues but it still cannot be fully explained to date. We reported a woman, 35 years old with systemic lupus erythematosus (SLE) who had been on steroid therapy and in the course of treatment developed into SJS after administration of anti-epileptic drug. Steroids have anti-inflammatory effects mainly due to decreased syntheses or suppression of inflammatory mediators. SJS still can develop in patient with SLE who had been on steroid therapy. Giving steroid that indicated for the treatment of a disease including SLE, cannot prevent the occurrence of an allergic event including SJS. The presence of steroid can extend the duration of starting the drug with the occurrence of SJS and reduce the severity of the disease. Steroid still have a role in treatment that can be used both in SJS and SLE.