Several methods have been used to detect infectious respiratory diseases, for example, by taking samples from blood, saliva, and phlegm. Although these methods generated high accuracy, they raised more problems that increased the risk of spreading and required more time to detect. Therefore, an accurate, quick, and low-cost device is required to help detect infectious respiratory diseases. This study proposes a new approach for detecting infectious respiratory diseases using an electronic nose (E-nose) through sweat samples from the human axilla. E-nose became safer by taking samples through the axillary because infectious respiratory diseases are not transmitted through sweat. This study proposes two new feature extraction techniques called stable value and highest slope. This study also proposes a stacked Deep Neural Network (DNN) for effective infectious respiratory disease detection. In the proposed stacked DNN, five fine-tuned DNN models obtained from hyperparameter tuning are stacked then the output of each DNN model became the input of the meta-model in the form of a fully connected layer. The proposed feature extraction method outperformed the existing feature extraction and was able to separate data between classes better. Furthermore, the proposed stacked DNN model generated an accuracy of 0.934 in the testing data, outperforming DNN single models and other state-of-the-art machine learning algorithms.

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Introduction: The high prevalence and incidence of complications due to diabetes mellitus impose an economic burden on patients and society. Aim: To obtain an overview of the cost of diabetes mellitus with complications and identify the factors that affect it. Methods: This study was conducted based on the perspective of health care providers. Results: The cost of illness for diabetes mellitus with complications was IDR 2,654,047,597 and an average cost of IDR 15,688,528/patient. Diabetes mellitus type 2 with peripheral circulation complications (E11.5) had the highest average cost (IDR 34,135,284/patient). The factors that significantly influenced direct medical costs were the length of stay, class of hospitalisation, and type of complications (Charlson comorbidity index). Conclusion: The results of this study indicate that the presence of complications increases the cost of diabetes mellitus treatment.

Background: The thyroid has a vital role in growth, neurodevelopment, reproduction, and metabolism. About 300 million people around the world had been reported to be suffering from thyroid disorders, but more than half were unaware. The factors of sex, age, weight of disease, and other accompanying conditions should be considered, otherwise, it will cause a long time treatment period in which the cost will become higher from year to year. Purpose: The systematic review aims to provide an overview of the financial burden caused by thyroid disease for the communities, governments and health care providers. Method: A systematic review of publications in several databases, namely PUBMED, SCIENCE DIRECT, DOAJ, SCOPUS and GOOGLE SCHOLAR. Results: Six research articles were obtained from publications selected for systematic review. The reviewed articles show overviews of the cost of thyroid disease in several countries. The financial burden of thyroid patients in some countries varies, with different perspectives. The lowest to highest cost ranges from 0.125 USD/patient – 8106 USD/patient. Conclusion: The study in this review illustrates the various costs in different countries; the cost of screening, and thyroid surgery has the largest contribution compared to other costs; research on the financial burden suffered by thyroid patients in the future must be carried out continuously and periodically to be able to estimate the cost of therapy more appropriately to provide a useful data for health care providers, governments and the community. Direct medical costs are the largest proportion.

Background: Gigantism is the excessive secretion of growth hormones (GH) during childhood and is mostly caused by benign pituitary adenomas. The signs and symptoms are not specific in early childhood due to growth spurt. An ischemic stroke is rarely present in pituitary adenoma, and here we present a case of ischemic stroke and atrial myxoma associated with pituitary gigantism. Case Presentation: The patient was an 18-year-old male who complained of continuous growth. In June 2016, the patient suffered from an embolic stroke, and in January 2017 he complained of fatigue and shortness of breath. The echocardiography showed a mass in the left atrium that was removed in March 2017 through open-heart surgery; the pathological histology confirmed a myxoma. The brain magnetic resonance imaging (MRI) showed a pituitary macroadenoma, and the growth hormone (GH) level was 20.6 ng/mL. In October 2019, the patient was referred to Dr. Soetomo Hospital. The height increased from 185 cm in 2017 to 205 cm in 2019. The height was 205cm, weight 85kg, body mass index 20.2 kg/m2, GH level >40 ng/mL, cortisol 11.24 ug/dL, prolactin 1.21 ng/mL, testosterone 425.6 ng/dL, free thyroxine (FT4) 1.03 ng/dL, and insulin-like growth factor 1 (IGF-1) 688 ng/mL. The patient was administered oral cabergoline 0.25 mg twice a week and had endoscopic endonasal transsphenoidal hypophysectomy (EETH). The patient developed postoperative polyuria after surgery which indicated diabetes insipidus, and the patient was administered desmopressin 0.05mg/12 h with fluid restriction. One week later, the morning cortisol level was low, and hydrocortisone therapy was administered and was tap-off. One month-post surgery, the level of morning serum cortisol was 0.86 µg/dL. Conclusion: This case is extremely rare and we demonstrated that the EETH surgery the stability of GH could be achieved.