Several investigations have revealed that COVID-19 causes a significant death rate due to acute respiratory distress syndrome, alterations in the quantity of ACE2 receptor expression, or the intensity of cytokine storm. Similarly, patients with hepatic impairment that are co-infected with SARS-CoV-2 are more likely to display upregulations of ACE2 receptors and cytokine storm overload, which exacerbates hepatic impairment, potentially increasing the death rate. Moreover, it is expected that the aging population develops a higher degree of hepatic fibrosis in association with other comorbid conditions that are likely to influence the course of COVID-19. Therefore, this research was developed to describe the differences in liver test parameters in elderly individuals with COVID-19 in relation to other inflammatory markers and outcomes. This current observational single-center research followed a case-control design of elderly patients hospitalized for SARS-CoV-2 infection. The research was conducted at a tertiary emergency hospital in western Romania during a two-year period. There were 632 patients included in the analysis that were split into two equal groups matched 1:1 based on gender and body mass index. Three hundred sixteen patients made the group of cases with COVID-19 patients older than 65 years, while the other half were the 316 patient controls with COVID-19 that were younger than 65 years old. Disease outcomes showed a higher prevalence of ICU admissions (22.8% vs. 12.7%, p-value < 0.001) and in-hospital mortality (17.1% vs. 8.9%, p-value = 0.002) in the group of cases. Specific and non-specific liver biomarkers were identified as risk factors for mortality in the elderly, such as ALP (OR = 1.26), LDH (OR = 1.68), AST (OR = 1.98), and ALT (OR = 2.34). Similarly, patients with APRI and NFS scores higher than 1.5 were, respectively, 2.69 times and, 3.05 times more likely to die from COVID-19, and patients with FIB-4 scores higher than 3.25 were 3.13 times more likely to die during hospitalization for SARS-CoV-2 infection. Our research indicates that abnormally increased liver biomarkers and high liver fibrosis scores are related to a worse prognosis in SARS-CoV-2 infected individuals.
Introduction: About 300.000 -350.000 Indonesian people suffer from cardiac arrest each year. Basic Life Support (BLS) is the first immediate response needed by cardiac arrest people, especially the out of hospital cardiac arrest (OHCA) patient. BLS that given from public to OHCA could increase the survival rate up to 2 -3x higher. Unfortunately, the Indonesian still did not know what is cardiac arrest, how to recognize it, and how to do BLS. Objective: The objective of this study was to identify the effect of BLS training in the knowledge and skill level of community in Sidodadi Village, Lawang, Indonesia. Method and Material: This experiment used a quasi-experimental design with 102 of the random sampling of people age 20-40 in Sidodadi Village, Lawang, Indonesia. The sample was given pre-test and post-test knowledge questioner before and after joining BLS training. The sample's skill was scored by an assistant doctor using a skill checklist. The data then analysed with a t-paired sample test, Wilcoxon sum rank test, and Pearson correlation. Result and Discussion: The score of women is higher than men both in pre-test and post-test, with the significance of p=0,039 for pre-test and p=0,001. 99% who joined BLS training have a significant increase in knowledge with p=0,001. Conclusion: The increase in knowledge and skill is correlated for an excellent and good level of the score, but not correlated in a bad level. About 99% of people who have joined BLS training have a significant increase in knowledge and skill. These trained people have the willingness to be a bystander for cardiac arrest people near them.Pendahuluan: Sekitar 300.000 -350.000 masyarakat Indonesia mengalami henti jantung setiap tahunnya. Basic Life Support (BLS) adalah pertolongan pertama yang diperlukan oleh korban henti jantung, terutama henti jantung yang terjadi diluar rumah sakit (out of hospital cardiac arrest-OHCA). BLS yang diberikan oleh awam pada OHCA mampu meningkatkan survival rate sebanyak 2 hingga 3x lipat. Sayangnya, masyarakat Indonesia masih banyak yang belum mengetahui apa itu henti jantung, bagaimana cara mengenalinya, dan bagaimana cara melakukan BLS. Tujuan: Tujuan penelitian ini adalah untuk mengetahui pengaruh pelatihan BLS terhadap tingkat pengetahuan dan keterampilan masyarakat dalam memberikan pertolongan pertama henti jantung di Desa Sidodadi, Kecamatan Lawang, Indonesia. Metode dan Bahan: Penelitian ini menggunakan desain quasi eksperimental dengan 102 random sampling dari penduduk berusia 20-40 tahun di Desa Sidodadi, Kecamatan Lawang, Indonesia. Sampel diminta untuk mengisi pretest pengetahuan, mengikuti pelatihan BLS, dan mengisi posttest pengetahuan. Keterampilan sampel dinilai oleh dokter muda menggunakan ceklis keterampilan. Data dianalisis dengan uji t berpasangan, wilcoxon sum rank test, dan uji korelasi pearson. Hasil dan Pembahasan: Nilai pretest dan postest perempuan lebih tinggi daripada pria, dengan nilai signifikansi p=0,039 untuk pretest dan p=0,001. 99% peserta yang mengikuti pelatihan BLS mengalami pen...
Measles is a highly infectious and sometimes deadly illness that is preventable with vaccination. The present research aims to analyze the most recent measles epidemic from Romania that occurred in a population with a falling desire to receive immunizations, by detailing the clinical picture and biological profile of hospitalized patients. A secondary goal of the present research is to identify characteristics that increase the likelihood of a longer hospitalization and the development of measles-related pneumonia. A retrospective cohort study was conducted to follow the course and effects of measles virus infection in adult hospitalized patients who were divided into two groups based on whether they had been in the hospital for more than 6 days or fewer than 6 days. A total of 114 adult patients with measles were eligible to participate in the trial if they had a positive measles-specific IgM antibody test resulting from the study. The average age in the short hospital stay group was 28.1 years, while the average age in the long hospital stay group was 31.9 years. There was a statistically significant difference in the number of Roma persons in the research groups, with 17.4 percent of them having a lengthy hospital stay compared to 5.9 percent in the group with a short hospital stay, according to the findings. It was observed that many patients had a long hospitalization associated with chronic lung disease (OR = 1.07), liver damage (OR = 1.66), Roma ethnicity (OR = 1.79), a long duration elapsed from the last MMR dose (OR = 2.02), elevated c-reactive protein (OR = 2.17), the presence of bilateral pulmonary condensations on X-ray (OR = 3.13), and elevated procalcitonin (OR = 3.49). The same significant independent risk factors were also associated with the development of pneumonia. It is of imperative need to address these risk factors in a patient with measles, moreover in association with an unknown status of vaccination. Vaccination awareness against measles must be pushed in Romania to determine a higher than 95% coverage. Significant efforts are still needed to ensure improved protection against measles epidemics within a specific region or population and, more importantly, in patients with significant risk factors for complications, as described in this study.
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