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"Tujuan : Membandingkan hasil biakan bakteri dari spesimen kornea yang diambil dengan metode kerokan dilanjutkan mikrohomogenisasi dan hasil biakan bakteri dari spesimen kornea yang diambil dengan apusan kornea. Desain: Penelitian ini adalah perbandingan potong lintang comparative cross sectional , Metode: Delapan belas subjek yang dibagi menjadi 2 kelompok terandomisasi, Kelompok A kerokan dilakukan pertama, apusan kedua , dan kelompok B apusan dilakukan pertama, kerokan kedua . Pada analisis data kedua metode kerokan dan apusan dipisahkan kemudian dibandingkan. Hasil: Proporsi Gram sesuai biakan pada teknik Kerokan-Mikrohomogenisasi sebesar 6/13 46.2 , proporsi Gram sesuai biakan pada teknik Apusan sebesar 5/13 38.5 . Nilai p uji McNemar adalah 1.000 p> 0.05 . Proporsi biakan positif pada teknik Kerokan-Mikrohomogenisasi sebesar 13/18 72.2 , proporsi biakan positif pada teknik apusan sebesar 9/18 50 . Nilai p uji McNemar adalah 0.219 p> 0.05 . Nilai uji kesesuaian Kappa dari teknik kerokan mikrohomogenisasi terhadap apusan kornea adalah 0.333. Kesimpulan: Hasil biakan bakteri dari spesimen kornea yang diambil dengan metode Kerokan dilanjutkan Mikrohomogenisasi memiliki angka biakan positif yang lebih besar dibandingkan biakan bakteri dari spesimen kornea yang diambil dengan apusan kornea namun tidak bermakna secara statistik. Kata kunci : apusan kornea; biakan bakteri; kerokan mikrohomogenisasi

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Purpose To compare the results of bacterial culture that specimens was taken by the corneal scrapings followed by microhomogenization method and bacterial culture that specimens was taken by corneal swabs. Methods This study was cross sectional comparisons, which 18 subjects were divided into two randomized groups Group A scrapings performed first, smear performed second , and group B smear performed first, scrapings performed second . In data analysis both methods scrapings and swabs are separated then compared. Results The proportion of Gram corresponding culture in scrapings Microhomogenization technique was 6 13 46.2 , the proportion of Gram corresponding cultures in smear technique was 5 13 38.5 . McNemar test p value is 1.000 p 0.05 . The proportion of positive cultures in scrapings Microhomogenization technique was 13 18 72.2 , the proportion of culture positive on smear technique was 9 18 50 . McNemar test p value is 0219 p 0.05 . Kappa suitability test value is 0.333. Conclusion The results of bacterial culture that specimens was taken by the corneal scrapings followed by microhomogenization have a culture positive larger than bacteria cultures that specimens was taken by a swab of the cornea but not statistically significant. Keywords bacterial cultures corneal swabs scrapings microhomogenization "

"Latar Belakang: Ulkus kornea bakteri merupakan penyebab utama buta kornea. Tatalaksana standar ulkus kornea bakteri hingga kini masih terfokus pada eliminasi infeksi melalui antibiotik. Meskipun amplifikasi bateri telah dihentikan, inflamasi sekunder kornea terus berlangsung dan mengakibatkan destruksi kornea lebih lanjut dan sikatriks yang tebal. Tujuan: Untuk mengevaluasi efektivitas dan keamanan terapi kombinasi keratektomi superfisial dengan transplantasi membran amnion dan plasma autolog topikal pada ulkus kornea bakteri sedang dan berat, dalam memfasilitasi penyembuhan dan meminimalisasi inflamasi sekunder kornea. Metode: Uji klinis terandomisasi terbuka. Pembedahan pada kelompok eksperimental dilakukan dalam 72 jam pasca pemberian tiga hari antibiotik inisial. Hasil: Enambelas mata dengan ulkus kornea bakteri diikutkan dalam penelitian ini. Seluruh ulkus sembuh dalam waktu 36 hari pada kelompok eksperimental, dan 54 hari pada kelompok kontrol. Kecepatan epitelisasi kelompok eksperimental lebih cepat dibandingkan dengan kontrol (1,82±1,11 vs 0,97±0,74 mm2/hari, p=0,04, uji t tidak berpasangan). Terdapat kecenderungan pembentukan sikatriks kornea yang lebih tebal pada kelompok kontrol. Pada akhir evaluasi, tajam penglihatan lebih baik didapatkan pada kelompok eksperimental (0,344 ± 0,15 vs 0,196 ± 0,12 pada ulkus sedang, p=0,2, uji t tidak berpasangan; dan 0,14 ± 0,05 vs 0,014 ± 0,02 pada ulkus berat, p<0,01, uji t tidak berpasangan). Tidak ada komplikasi pada kelompok eksperimental, namun terdapat dua komplikasi pada kelompok kontrol. Simpulan: Terapi kombinasi keratektomi superfisial dengan transplantasi membran amnion dan plasma autolog topikal pada ulkus kornea bakteri terbukti lebih efektif dan aman dibandingkan terapi antibiotik konvensional. Terapi ini mempercepat epitelisasi dan penyembuhan ulkus, sehingga membentuk sikatriks kornea yang lebih tipis dengan tajam penglihatan lebih baik.

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Background: Bacterial corneal ulcer is a leading cause of corneal blindness. Up to now, the standard treatment for bacterial corneal ulcer is limited to the elimination of infection with antibiotic. However, the secondary tissue inflammation may still persist, leading to further corneal tissue destruction and dense corneal scar.

Objectives: To evaluate the efficacy and safety of superficial keratectomy, freeze-dried amniotic membrane transplantation and topical autologous plasma as a novel combination therapy in moderate and severe bacterial corneal ulcer, for promoting corneal wound healing and minimizing second injury of the cornea.

Methods: An open randomized controlled trial. The operation in experimental group was performed within 72 hours after three days application of initial antibiotic.

Results: Sixteen eyes of bacterial corneal ulcers were enrolled. All ulcers were healed within 36 days in the experimental group, compared to 54 days in the control group. Epithelialization rate of the experimental group was significantly faster than the control group (1,82±1,11 vs 0,97±0,74 mm2/day, p=0,04, unpaired t-test). Dense corneal scarring was more likely marked in the control group. Higher visual acuity at the last follow-up was achieved in the experimental group (0,344±0,15 vs 0,196±0,12 for moderate cases, p=0,2, unpaired t-test; and 0,14±0,05 vs 0,014±0,02 for severe cases, p<0,01, unpaired t-test). None complication was found in experimental group, while two complications (impending perforation and limbal damage) were noted within the control group.

Conclusions: Combination of superficial keratectomy with amniotic membrane transplantation and topical autologous plasma shows its benefits and safety for bacterial corneal ulcers. It promotes early epithelialization and corneal wound healing, thus achieving less corneal scarring with better visual acuity than conventional antibiotic therapy."

"ABSTRAKTujuan Untuk mengetahui perbadingan efektivitas dan keamanan antara fakoemulsifikasi torsional dan transversal menggunakan parameter phaco time dan perubahan sel endotel dan ketebalan kornea sentral Metode Penelitian prospektif menggunakan katarak senilis NO 3 4 LOCS III yang dilakukan randomisasi menjadi dua kelompok torsional Ozil IP dan transversal Ellips FX Keluaran primer berupa phaco time sel endotel kornea ketebalan kornea sentral tajam penglihatan terkoreksi pada hari pertama ketujuh dan ke 30 pasca operasi Hasil Penelitian ini menggunakan 61 pasient Karakteristik dasar setara dan dapat dibandingkan Phaco time torsional CDE memiliki nilai kecil hingga hanya 1 3 phaco time transversal EFX Penurunan ECD kelompok torsional 7 9 dan kelompok transversal 8 9 Tidak ada perbedaan bermakna pada perubahan ECD dan CCT antara fakoemulsifikasi torsional dan transversal Simpulan Efektivitas dan keamanan kedua mesin fakoemulsifikasi torsional dan transversal tidak berbeda signifikan.

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ABSTRACT

Purpose To compare the effectivity and safety between torsional and transversal phacoemulsification using intraoperative parameter phaco time and postoperative parameter endothelial cells and central corneal thickness changesMethods This prospective study with senile cataract eyes NO 3 4 LOCS III which randomized to have phacoemulsification using torsional Ozil IP or transversal Ellips FX Primary outcomes were phaco time endothelial cell density ECD central corneal thickness CCT corrected distance visual acuity with 1 7 and 30 days after phacoemulsificationResults The study included 61 patients Baseline characteristic were comparable The phaco time torsional CDE only one third of phaco time transversal EFX The results of the percentage of ECD loss were 7 9 in torsional and 8 9 in transversal No difference in ECD and CCT changes between torsional and transversal statistically Conclusions The effectivity and safety of torsional and transversal phacoemulsification did not differ significantly."

"Latar belakang: Ulkus kornea adalah salah satu penyakit infeksi mata yang banyak ditemukan di negara berkembang termasuk Indonesia. Tatalaksana ulkus kornea bakteri konvensional umumnya dapat menimbulkan jaringan parut kornea permanen yang dapat menurunkan tajam penglihatan. Penggunaan transplantasi membran amnion (TMA) pada ulkus kornea dapat mempercepat proses penyembuhan dan mengurangi terbentuknya jaringan parut kornea. Membran amnion diduga menjadi kerangka baru dan mengekspresi beberapa komponen biologis yang berperan membantu proses epitelisasi dan pembentukan jaringan parut di kornea. Tujuan: Mengetahui dan membuktikan perbedaan perubahan klinis pada kelompok TMA dan terapi standar (non-MA) pada pasien dengan ulkus kornea bakteri, perbedaan perubahan kadar protein TNF-, MMP-9, TGF-β1 di air mata dan ekspresi mRNA TNF-, MMP-9, TGF-β1, dan TGF-β2 di air mata dan kornea. Metode: Penelitian tahap pertama, dilakukan penilaian klinis sebelum dan sesudah pada grup TMA dan terapi standar (non-TMA) dengan menilai tajam penglihatan, waktu epitelisasi total, waktu pembentukan sikatrik total dan derajat sikatrik serta uji kadar protein TNF-, MMP-9, TGF-β1 di air mata dengan pemeriksaan ELISA. Penelitian tahap kedua, dilakukan pemeriksaan ekspresi mRNA TNF-, MMP-9, TGF-β1, dan TGF-β2 di air mata dan kornea dengan pemeriksaan quantitative Reverse Transcriptase-Polymerase Chain Reaction (qRT-PCR). Hasil: Hasil penelitian pertama, pada grup TMA terjadi perbaikan yang signifikan bermakna pada tajam penglihatan (p=0.001), waktu epitelisasi total (p=0.002), waktu terbentuk sikatrik total (p=0.005), dan derajat sikatrik (p=0.001) dibandingkan grup non-TMA. Hasil kadar proteinTNF-, MMP-9, dan TGF-β1 di air mata tidak terjadi perubahan yang bermakna sebelum dan sesudah dan tidak terdapat perbedaan bermakna pada kedua grup (p>0.005). Pada hasil penelitian kedua, ekspresi mRNA TNF-α menurun paling tinggi pada grup TMA (0.824 ± 0), MMP-9 meningkat paling tinggi pada grup TMA (66.698 ± 24.948), TGF-β1 meningkat paling tinggi pada grup TMA (34.425 ± 14.025), sedangkan TGF-β2 mengalami peningkatan tertinggi pada grup non-TMA (114.049 ± 55.344). Kesimpulan: Terdapat perbaikan klinis yang signifikan pasca TMA, sejalan dengan ekspresi gen dari molekul yang terkait ditandai dengan penurunan inflamasi, re-epitelisasi yang lebih cepat, dan pengurangan pembentukan sikatrik. Kadar protein dan ekspresi gen molekul inflamasi di air mata tidak dapat dijadikan penanda untuk proses yang terjadi di kornea.

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Background: Corneal ulcer is one of ocular infection disease that is commonly found in developing country like Indonesia. The conventional treatment for bacterial corneal ulcer usually causes the forming of permanent corneal scar which results in decrease of visual acuity. The use of amniotic membrane transplantation (AMT) in corneal ulcer is believed can shorten the healing process and reduce corneal scar. Amniotic membrane is expected to become as a new scaffold and have several biological properties that play a role in epithelization process and fibrotic tissue formation.

Objective: To evaluate and establish the clinical differences on amniotic membrane transplantation and standard therapy of patients with bacterial corneal ulcer, and laboratory evaluation of protein level and mRNA expression changes of TNF-, MMP-9, TGF-β1 and TGF-β2 in tears and corneal tissue.

Method: This study was divided into two phases on two groups of AMT and standard therapy group (non-AMT). On the first phase, clinical evaluation was examined include visual acuity, total duration of epithelization, total duration of scar formation and the degree of corneal scar, along with laboratory of protein level of TNF-, MMP-9, TGF-β1 in tears with ELISA. On the second phase, mRNA expression of TNF-, MMP-9, TGF-β1, and TGF-β2 in tears and cornea were examined with quantitative Reverse Transcriptase-Polymerase Chain Reaction (qRT-PCR).

Result: The result of first phase on TMA group showed significant improvement on visual acuity (p=0.001), total duration of epithelization (p=0.002), total duration of scar formation (p=0.005), and cicatrix degree (p=0.001) compared to non-TMA group and a non-significant result on protein level of TNF-, MMP-9, TGF-β1 in tears on both groups (p>0.005).On the second phase, mRNA expression of TNF-showed the highest decrease on TMA group (0.824 ± 0), MMP-9 showed the highest increase on group TMA (66.698 ± 24.948),TGF-β1 expression increased the highest on TMA group (34.425 ± 14.025), whereas TGF-β2 showed the highest result on non-TMA group (114.049 ± 55.344).

Conclusion: There was significant clinical improvement observed in TMA group parallel with related molecular genetic expression, indicated decreasing of inflammation, faster re-epithelization, and less dense scar formation. Protein level and genetic molecular expression in tears are poor predictors of processes occurring in the cornea."

"Penelitian ini bertujuan untuk mengetahui perubahan ketebalan kornea sentral CCT , morfologi dan kurvatura kornea penderita miopia sedang pada pemakaian extended wear EW lensa kontak lunak LKL silikon hidrogel SiH lotraficon B terhadap daily wear DW selama 1 bulan pemakaian. Uji klinik tersamar tunggal dilakukan pada 34 subjek 68 mata dengan desain 2 kelompok paralel, yaitu kelompok EW dan DW. Morfologi sel endotel dan CCT diukur menggunakan mikroskop spekular dan keratometri dengan wavelight oculyzer. Tidak didapatkan perubahan CCT, morfologi, dan kurvatura kornea pada kedua grup pasca 1 bulan pemakaian LKL. Dari segi pengaruhnya terhadap CCT, LKL ini dapat digunakan secara extended.

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Purpose of this study is to know the changes of corneal thickness CCT , endothelial morphology and curvature on the use of extended wear EW versus daily wear DW lotraficon B silicon hydrogel SiH soft contact lenses SCL for 1 month on moderate myopia. A single blind randomized controlled trial on 34 subject 68 eyes design with 2 parallel groups EW and DW. Endothelial cell morphology and CCT was measured by specular microscope, Keratometry by wavelight oculyzer. There were no changes on CCT, endothelial morphology and curvature between two groups after 1 month. Viewing from the effect on corneal thickness, this SCL are possible to be used in an extended manner."

"ABSTRAKTesis ini bertujuan menilai perbandingan efektivitas terapi adjuvan injeksi kombinasi intrastromal IS dan intrakameral IK vorikonazol VCZ dengan intrastromal IS VCZ pada ulkus kornea jamur derajat sedang akibat Aspergillus fumigatus. Uji eksperimental tersamar acak dilakukan pada 11 kelinci albino New Zealand white yang terbagi menjadi 3 kelompok, yaitu kontrol, injeksi intrastromal, serta intrastromal dan intrakameral. Parameter yang dinilai adalah perubahan klinis, mikologis, dan histopatologik kornea. Sebagian besar subjek pada grup kombinasi memperlihatkan kecendrungan perbaikan klinis dibandingkan kelompok kontrol namun tidak bermakna secara statistik p>0,05 . Pemeriksaan histopatologik memperlihatkan kecenderungan peningkatan jumlah sel radang pada kelinci yang dilakukan inokulasi pada kedua matanya.

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ABSTRACTThe purpose of this study was to compare the efficacy of intrastromal IS and combined with intracameral IK voriconazole VCZ therapy in moderate keratomycosis caused by Aspergillus fumigatus in rabbits. A randomized, masked, controlled experimental study was administered on 11 albino New Zealand white rabbits, which latter allocated into three different treatment groups of control, intrastromal VCZ and combinations. Clinical grading was performed at multiple times, while mycology analysis and histopathological examination were performed after treatment. All subjects in combination groups demonstrated a tendency of better clinical response with decreasing size of epithelial defect and infiltrate but statistically not significant p 0,05 . "

"[ABSTRAKTujuan: Untuk mengevaluasi perbandingan ketebalan kornea dan morfologi sel endotel penderita miopia sedang dengan pemakaian harian lensa kontak lunak hidrogel konvensional (nelfilcon A) terhadap silikon hidrogel (lotrafilcon B) selama 1 bulan.Metode: Penelitian ini merupakan uji klinis tersamar tunggal pada 17 pasien (34 mata) dengan miopia sedang yang dibagi secara acak untuk memakai lensa kontak lunak nelfilcon A atau Lotrafilcon B. Ketebalan kornea sentral (CCT), Coefficient of variation (CV), dan persentase sel heksagonal (6A) diukur menggunakan mikroskop spekuler non-con robo Konan sebelum penelitian (pre-fitting), 1 minggu serta 1 bulan setelah pemakaian lensa kontak lunak. Pasien juga dievaluasi mengenai adanya efek samping subyektif dan komplikasi selama memakai lensa kontak.Hasil: Terdapat 64,7% subyek dengan riwayat pemakaian lensa kontak lunak sebelumnya, dimana 52,9% diantaranya adalah pemakai hidrogel konvensional yang tidak teratur. Setelah evaluasi 1 bulan, tidak didapatkan perbedaan yang bermakna antara pemakai Nelfilcon A dengan Lotrafilcon B dalam hal: ketebalan kornea sentral (p=0,285; uji Mann Whitney), CV (p=0,587; uji t tidak berpasangan), dan 6A (p=0,353; uji t tidak berpasangan). Analisis general linear model terhadap waktu pengukuran mendapatkan perbedaan yang bermakna pada seluru subyek meliputi penurunan CCT (p=0,001) dan CV (p=0,001), serta peningkatan 6A (p=0,022) pada test within subject effect.Simpulan: Tidak terdapat perbedaan CCT, CV, dan 6A yang bermakna secara statistik antara pada pemakaian harian lensa kontak lunak Lotrafilcon B dan Nelficon A. Pasien dengan riwayat penggunaan lensa kontak sebelumnya mendapatkan manfaat dengan pemakaian nelfilcon A dan lotrafilcon B dalam hal perbaikan hipoksia jaringan berupa: penurunan ketebalan kornea dan perbaikan morfologi sel endotel.

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ABSTRACTObjective: To compare corneal thickness and endothelial cell morphology in myopic patients wearing 1 month hydrogel conventional and silicon hydrogel contact lenses in daily wear.Methods: This is a prospective, single blind, randomized study. Seventeen (34 eyes) myopic patients were randomly assigned to wearing either nelfilcon A or lotrafilcon B. Central corneal thickness (CCT), Coefficient of variation (CV), and percentage of six-sided cell (6A) were examined using specular microscope non-con robo Konan. Changes in CCT, CV, and 6A were evaluated before contact lenses fitting as well as 1 week and 1 month after the treatment. Patients were also evaluated for any subjective side effects and complications during the treatment period.Results: There were 64,7% subjects with history of contact lens weares and 52,9% of them was hydrogel wearers. After 1 month daily wear of nelfilcon A and lotrafilcon B, no statistically differences changes in CCT (p=0,285; Mann Whitney test), CV (p=0,587; unpaired t test) dan 6A (p=0,353; unpaired t test). General linear model analysis in follow up evaluation with test of within subject effect revealed decreased CCT(p=0,001) and CV (p=0,001), also increased 6A (p=0,022) in all subjects.Conclusions: There were no statistically difference CCT, CV, and 6A between daily wear of nelfilcon A and lotrafilcon B. Subjects with history of contact lens weares gained advantages in oxygen availability, which is decrease in corneal thickness and improvement of endothelial cell morphology., Objective: To compare corneal thickness and endothelial cell morphology in myopic patients wearing 1 month hydrogel conventional and silicon hydrogel contact lenses in daily wear.Methods: This is a prospective, single blind, randomized study. Seventeen (34 eyes) myopic patients were randomly assigned to wearing either nelfilcon A or lotrafilcon B. Central corneal thickness (CCT), Coefficient of variation (CV), and percentage of six-sided cell (6A) were examined using specular microscope non-con robo Konan. Changes in CCT, CV, and 6A were evaluated before contact lenses fitting as well as 1 week and 1 month after the treatment. Patients were also evaluated for any subjective side effects and complications during the treatment period.Results: There were 64,7% subjects with history of contact lens weares and 52,9% of them was hydrogel wearers. After 1 month daily wear of nelfilcon A and lotrafilcon B, no statistically differences changes in CCT (p=0,285; Mann Whitney test), CV (p=0,587; unpaired t test) dan 6A (p=0,353; unpaired t test). General linear model analysis in follow up evaluation with test of within subject effect revealed decreased CCT(p=0,001) and CV (p=0,001), also increased 6A (p=0,022) in all subjects.Conclusions: There were no statistically difference CCT, CV, and 6A between daily wear of nelfilcon A and lotrafilcon B. Subjects with history of contact lens weares gained advantages in oxygen availability, which is decrease in corneal thickness and improvement of endothelial cell morphology.]"

"Penelitian ini bertujuan menilai dan membandingkan efektivitas injeksi subkonjungtiva bevacizumab dosis 5 mg dengan dosis 2.5 mg dalam menurunkan area neovaskularisasi kornea. Sampel adalah dua puluh empat pasien dengan neovaskularisasi kornea oleh karena berbagai etiologi. Pemeriksaan pada sampel dilakukan sebelum, satu minggu setelah injeksi dan empat minggu setelah injeksi yang meliputi penilaian area neovaskularisasi kornea dengan menggunakan image J analysis, pemeriksaan tajam penglihatan tanpa dan dengan koreksi, derajat kekeruhan kornea serta kadar vascular endothelial growth factor (VEGF) air mata. Pada satu minggu dan empat minggu paska injeksi perubahan area neovaskularisasi kornea pada dosis 5 mg (5.21% dan 5.37%) lebih besar dibandingkan dosis 2.5 mg (3.77% dan 4.13%). Hasil yang serupa juga didapatkan pada etiologi non-infeksi dan area neovaskularisasi kornea yang melibatkan lebih dari dua kuadran kornea. Pada keluaran sekunder yaitu tajam penglihatan, derajat kekeruhan kornea dan kadar VEGF air mata di kedua dosis cenderung stabil jika dibandingkan sebelum dan sesudah injeksi. Injeksi subkonjungtiva bevacizumab dosis 5 mg menurunkan area neovaskularisasi kornea lebih banyak dibandingkan dosis 2.5 mg terutama pada etiologi non-infeksi dan keterlibatan kuadran kornea yang meliputi lebih dari dua kuadran.

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This study aim to assess and compare the effectiveness of subconjunctival bevacizumab injection 5 mg with 2.5 mg in decreasing the area of corneal neovascularization. Samples consist of twenty-four patients with corneal neovascularization due to various etiologies. The examinations were taken at each visit before injection, 1 week after injection and 4 weeks after injection . Changes in neovascularization evaluated by using image J analysis, visual acuity, density of corneal haziness and level of vascular endothelial growth factor (VEGF) in tears were documented every visit. At 1 week and 4 weeks after injection, changes of neovascularization were higher in 5 mg (5.21% and 5.37%) compare to 2.5 mg (3.77% and 4.13%). The same results were also found in non-infection patient and patient involving more than two quadrants cornea. All of the secondary outcomes showed a stable result before and after injection between the two injections dose. Subconjunctival bevacizumab injection 5 mg is more effective in decreasing corneal neovascularization compare to 2.5 mg especially in non-infection patient and patient involving more than two quadrants cornea. "

"Latar Belakang: Acute Kidney Injury pada COVID-19 merupakan komplikasi penting dan dikaitkan dengan peningkatan risiko kematian diduga diperantarai kondisi inflamasi dan disregulasi imun, baik di awal maupun selama perawatan. Tujuan: Untuk mengetahui hubungan antara IL-6, IL-10, TNF-" dengan AKI dan memprediksi perburukan hematuria, dan kejadian AKI Metode: Studi potong lintang dan prospektif kohort melibatkan 43 pasien COVID-19 derajad sedang dan berat yang dirawat di Rumah Sakit Pertamina Pusat di Jakarta, Indonesia dari bulan November 2020 hingga Januari 2021. Selama observasi dilakukan pemeriksaan darah lengkap, serum kreatinin, urinalisis, kadar IL-6, IL-10, TNF-" pada hari pertama dan hari ketujuh pengobatan atau sebelum hari ketujuh jika pasien meninggal atau dipulangkan, dan perubahannya di analisis. Insiden AKI ditentukan ketika perubahan serum kreatinin dan urin output memenuhi kriteria pedoman Kidney Disease Improving Global Outcomes. Uji korelasi dilakukan terhadap peningkatan sitokin dengan perubahan hematuria dan kreatinin. Uji Wilcoxon dilakukan untuk mengetahui perbedaan kadar sitokin diantara status albuminuria. Selanjutnya dilakukan uji Receiver Operator Characteristic untuk melihat kemampuan prediksi IL-6, IL-10, TNF-" terhadap perburukan hematuria dan kejadian AKI, menggunakan AUC minimal 0,7 dengan batas bawah IK 95% lebih dari 0,5 dan nilai p <0,05 Hasil: Terdapat korelasi antara peningkatan kadar serum IL-10 dengan perubahan serum kreatinin (r= -0,343; p 0,024) tetapi tidak pada perubahan IL-6 dan TNF-a. Perubahan hematuria tidak berkorelasi dengan peningkatan ketiga kadar sitokin. Juga tidak ada perbedaan dalam kadar sitokin di antara kelompok albuminuria. Kadar serum TNF-" dihari pertama perawatan dapat memprediksi AKI pada hari ke tujuh, AUC 85%; p=0,045 (IK 0,737-0,963), tetapi tidak dapat memprediksi perburukan hematuria Kesimpulan: Terdapat korelasi antara peningkatan IL-10 dengan perubahan serum kreatinin. TNF-! pada hari pertama perawatan dapat memprediksi kejadian AKI di hari ketujuh perawatan pasien COVID-19 derajat sedang dan berat.

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Background: Acute Kidney Injury is an important complication and is associated with increased risk of death in COVID-19 due to inflammatory conditions and immune dysregulation, both at the beginning and during treatment. Aim: To determine the relationship between IL-6, IL-10, TNF-α with AKI and their ability to predict the worsening of hematuria, and the incidence of AKI. Methods: 43 moderate and severe COVID-19 patients treated from November 2020 to January 2021 at Pertamina Central Hospital in Jakarta, Indonesia were included in this cross-sectional and prospective cohort study. During observation, tests including complete blood count, serum creatinine, urinalysis, levels of IL-6, IL-10 and TNF-α were performed on the first and seventh day of treatment, or before day 7 if the patient died or was discharged, and the changes were analyzed. The incidence of AKI is determined when changes in serum creatinine and urine output meet the criteria in the Kidney Disease Improving Global Outcomes guidelines. Correlation test was performed on increased cytokines with changes in hematuria and creatinine. Wilcoxon test was performed to obtain differences in cytokine levels among albuminuria status. Receiver Operator Characteristic test was then carried out to see the predictive ability of IL-6, IL-10, TNF- α on the worsening of hematuria and the incidence of AKI. Results: There was a correlation between increased serum IL-10 levels with changes in serum creatinine (r= -0.343; p 0.024), but not in IL-6 and TNF-a levels. On the other hand, changes in hematuria did not correlate with an increase in the levels of the three cytokines. There was also no significant difference in the levels of cytokines among albuminuria groups. Serum TNF-! levels on the first day of treatment were able to predict AKI on the seventh day (AUC 85%; p=0.045; 95%CI 0.737-0.963), but did not predict the worsening of hematuria. Conclusion: There was a correlation between increased serum IL-10 with changes in serum creatinine. TNF-! on the first day of treatment can predict the incidence of AKI on the seventh day of treatment for moderate and severe COVID-19 patients."

"Salah satu permasalahan kesehatan utama di Indonesia merupakan penyakit infeksi saluran pernapasan. Penyakit saluran pernapasan dapat diakibatkan oleh jamur, sehingga disebut mikosis paru. Jamur-jamur penyebab infeksi saluran pernapasan pada manusia terdiri atas banyak spesies mulai dari spesies-spesies Candida sp. hingga spesies jamur penyebab mikosis yang lebih patogen, yaitu Aspergillus fumigatus. Metode biakan spesimen respirasi berupa sputum dapat digunakan untuk mengidentifikasi spesies jamur penyebab mikosis paru. Penelitian ini dilakukan untuk mengetahui perbandingan hasil kultur yang dapat tumbuh pada media agar saboraud dekstrosa dengan metode biakan konvensional menggunakan agar miring dan metode biakan High Volume Culture pada cawan petri (plate). Penelitian ini menggunakan desain potong lintang di mana hasil kultur diidentifikasi dari sputum yang dibiakan pada metode yang berbeda. Data hasil kultur pada dua metode berbeda tersebut kemudian dianalisis korelasinya dengan uji McNemar dan didapatkan nilai kemaknaan p=0.000. Hubungan antara metode biakan dengan hasil kultur mempunyai korelasi yang signifikan (p<0.05). Oleh karena itu, metode High Volume Culture merupakan metode yang lebih baik untuk menumbuhkan lebih banyak koloni jamur termasuk Aspergillus fumigatus dibandingkan dengan metode kultur konvensional.

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One of the main health problems in Indonesia is respiratory disease. Respiratory disease can be caused by fungus, so-called lung mycosis. The fungi species that cause respiratory infections in humans are ranged from Candida sp. to more dangerous species such as Aspergillus fumigatus. Culture methods using respiratory specimen especially sputum can be used to identify species of fungi that cause pulmonary mycosis. This study was conducted to compare the culture results between conventional culture methods on sloped agar and high volume culture method on plate. This study used a cross-sectional design in which the data of culture results were obtained from different culture methods. High volume culture method grew more colonies including Aspergillus fumigatus than conventional culture method which grew no Aspergillus fumigatus. The correlation of data between culture methods and culture results were analyzed with McNemar test and it showed p=0.000. The relationship between the culture method and culture results has a significant correlation (p<0.05). Therefore, high volume culture was a better method to grow more fungal colonies including Aspergillus fumigatus than conventional culture method."