Avian Influenza H5N1 termasuk ke dalam kelompok penyakit menular strategis dan bersifat zoonosis mematikan baik pada hewan maupun manusia yang terinfeksi. Salah satu strategi utama dalam pencegahan AI di Indonesia yaitu dengan vaksinasi. Efektivitas vaksin AI akan lebih baik apabila strain virus dalam vaksin yang digunakan homolog dengan strain virus yang ada di lapangan. Penelitian ini bertujuan untuk mengetahui histopatologi limpa ayam petelur pascavaksinasi AI-H5N1 isolat dari Bali dengan parameter diameter folikel limfoid pulpa putih limpa. Sebanyak 36 ekor ayam petelur strain Novogen Brown digunakan untuk sampel penelitian. Sampel dibagi menjadi 2 kelompok yaitu P0/kelompok kontrol tanpa perlakuan dan P1 kelompok dengan perlakuan vaksinasi AI-H5N1 isolat dari Bali. Masing-masing kelompok terdiri dari 18 ekor ayam petelur. Ayam dipelihara sejak berusia 1 hari. Vaksinasi dilakukan setelah ayam berumur 5 minggu dan di booster pada umur 10 minggu dengan dosis vaksin 0,5 ml/ekor. Pengambilan sampel organ limpa dilakukan tiga minggu pascavaksinasi booster untuk pembuatan preparat histopatologi. Data hasil pemeriksaan preparat histopatologi limpa ayam petelur dianalisis dengan uji-t. Hasil penelitian pengukuran pada organ limpa, menunjukkan rerata diameter folikel limfoid pulpa putih limpa ayam petelur dengan perlakuan vaksinasi AI-H5N1 isolat dari Bali memiliki diameter lebih besar dibandingkan dengan kelompok ayam yang tidak divaksinasi. Simpulan dari penelitian ini adalah vaksinasi AI-H5N1 isolat Bali berpengaruh nyata terhadap penambahan diameter folikel limfoid pulpa putih limpa ayam petelur pascavaksinasi.

Background Hyperglycemic crisis is emergency caused by metabolic problems due to uncontrolled diabetes mellitus. Hyperglycemic crisis consists of Hyperosmolar Hyperglycemic State (HHS) and Diabetic Ketoacidosis. Both are caused by relative or absolute deficiency of insulin; deficiency of insulin could be caused by type 1 and type 2 diabetes. Case presentation A 46-year-old woman came to the emergency room of Unggul Karsa Medika Hospital presenting with breathlessness which had occurred for a week. Her breathlessness was more severe on the day she presented to the emergency room. One week before, she went to a clinic nearby because of epigastric pain, but after returning home she felt breathless. After a few days, her breathlessness started to worsen, so she decided to go to emergency room. The patient had severe acidosis and high blood glucose. Hyperglycemia protocol of rehydration and insulin drip intravenously, accompanied by sodium bicarbonate and potassium chloride were given. Mechanical ventilation was used. The patient was healed and discharged safely after 9 days of hospitalization. Conclusion Hyperglycemic crisis is one of true emergency that can lead to mortality, thus prompt diagnosis and treatment should be done. It is important for clinicians to differ between HHS and DKA. HHS is caused by the relative or absolute deficiency of insulin while DKA is characterized by absolute insulin deficiency which prevents the body from metabolizing carbohydrates and results in severe hyperglycemia.  In DKA and HHS the main goal of therapy is to rehydrate, correct hyperglycemia, and to correct electrolyte imbalances.