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"Background: older people contributed to 38.6% of death cases related to COVID-19 in Indonesia. Data regarding clinical profile of hospitalised elderly with COVID-19 in Indonesia were still lacking. Older people are at-risk population in the pandemic, whom we should pay attention to. Methods: this single centre descriptive study utilised complete data of elderly inpatients with COVID-19 in Indonesia’s national general hospital from April to late August 2020. The data consisted of clinical characteristics, symptoms, comorbidities, multimorbidity, and mortality outcome. Results: among elderly patients (n=44), a majority of patients were aged 60-69 years (68%), were male (66%), and had no history of close contact with COVID-19 patient (86%). The most common symptoms were fever, cough and shortness of breath (classic symptoms of COVID-19), whereas the most common chronic diseases were diabetes mellitus, hypertension, and malignancy. Multimorbidity was only found in 14% of patients, all of whom remained alive following SARS-CoV-2 infection. The death rate among elderly inpatients with COVID-19 in this study was 23%, and male older adults contributed to 90% of death cases. Conclusion: male patients dominated both confirmed cases and death cases among elderly with COVID-19. Classic symptoms of COVID-19 were only found in about half of the study patients. Non-survivors had higher percentage of the classic symptoms of COVID-19 than survivors. Atypical COVID-19 presentations are possible in older adults. We postulated that immunosenescence and sex-specific immunoregulatory function play an important role in causing death in this study cohort."

"Suitable for medical students taking medical biochemistry, this title links biochemical concepts to physiology and pathophysiology, using hypothetical patient vignettes to illustrate core concepts. It helps medical students understand the importance of the patient and bridges the gap between biochemistry, physiology, and clinical care."

"Secara umum, jumlah pasien COVID-19 yang mendapatkan perawatan di rawat inap lebih banyak daripada di ICU, sehingga menjadikannya urgensi untuk memberikan pelayanan terbaik dengan memberikan terapi pengobatan yang efektif agar jumlah pasien sembuh terus bertambah. Dalam peresepan obat dapat terjadi kesalahan yang akan menyebabkan pengobatan bagi pasien COVID-19 tidak efektif, salah satunya Masalah Terkait Obat (MTO). Penelitian ini bertujuan untuk mengidentifikasi MTO pada pasien COVID-19 rawat inap di RSUI tahun 2020. Penelitian ini merupakan penelitian deskriptif dengan desain penelitian cross sectional. Data yang digunakan merupakan data sekunder yang diambil secara retrospektif dari resep dan rekam medis pasien. Klasifikasi MTO dalam penelitian ini mengacu pada klasifikasi Hepler dan Strand. Identifikasi dilakukan pada 406 pasien COVID-19 yang memenuhi kriteria inklusi. Hasil dari penelitian menunjukkan adanya MTO sebanyak 26 kejadian pada 22 pasien dari 406 pasien COVID-19 rawat inap di RSUI tahun 2020 dengan persentase indikasi yang tidak diobati sebesar 3,85%, kesalahan pemilihan obat 11,54%, kegagalan dalam penerimaan obat 23,08%, reaksi obat tidak diinginkan 19,23%, potensi interaksi obat 42,31%, dan tidak ditemukan kejadian dosis subterapi, dosis berlebih, serta penggunaan obat tanpa indikasi. Berdasarkan hasil identifikasi tersebut, dapat disimpulkan bahwa terapi pengobatan pasien COVID-19 rawat inap di RSUI berpotensi mengalami MTO.

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In general, the number of COVID-19 patients who are hospitalized is more than in the ICU, thereby this becomes an urgency to provide the best service by providing effective treatment to increase the number of recovered patients. In prescribing drugs, errors can occur which will cause treatment for COVID-19 patients to be ineffective, one of which is Drug-related Problems (MTO). This study aims to identify DRP in hospitalized COVID-19 patients at RSUI in 2020. This study is a descriptive study with a cross-sectional study design. The data used in this study are secondary data taken retrospectively from prescriptions and patient medical records. The DRP classification used in this study refers to the Hepler and Strand classifications. Identification was carried out on 406 COVID-19 patients who met the inclusion and exclusion criteria. The results of the study indicated that there were 26 DRP events in 22 out of 406 hospitalized COVID-19 patients at RSUI with the proportion of events for untreated indications 3,85%, improper drug selection 11,54%, failure to receive drugs 23,08%, adverse drug reactions 19,23%, potential drug interactions 42,31%, and there were no incidence of subtherapeutic dosage, overdosage, and drug use without indication. Based on the results, it can be seen that the treatment for hospitalized COVID-19 patients at RSUI has the potential to experience drug related problems."

"Latar Belakang: Pandemi Corona Virus Disease 2019 (COVID-19) yang disebabkan oleh Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) berawal dari Wuhan, Cina sejak Desember 2019. Jakarta menjadi salah satu episentrum pandemic COVID-19 di Indonesia. Data penelitian COVID-19 di Indonesia masih sangat terbatas, sehingga diperlukan penelitian untuk mengetahui karakterisik klinis, radiologis, laboratorium dan derajat klinis. Metode Penelitian: Penelitian ini diambil dari 1070 pasien yang dirawat di Rumah Sakit Darurat Wisma Atlet yang menjalani skrining gejala klinis, radiologi toraks, laboratorium dan serologi SARS-CoV-2kemudian dilanjutkan dengan pemeriksaan swab RT-PCR. Hasil skrining swab RT PCR pada 1070 pasien terdapat 836pasien terkonfirmasiCOVID-19, lalu diskrining dari 836 pasien yang memiliki radiologi toraks dan laboratorium lengkap ada 413 pasien. Hasil Penelitian: Pasien terkonfirmasi COVID-19 derajat ringan-sedang didominasi oleh pasien laki-laki(55,4%) dengan kelompok usia < 60 tahun (91,8%) dan rerata umur 39,94±14,17 tahun. Sebagian besar pasien tidak memiliki komorbid, tetapi komorbid paling banyak adalah hipertensi (4,1%). Derajat klinis pasien yang dirawat paling banyak kasus asimtomatik (46%), sedang (31,5%) dan ringan (22,5%). Gejala yang sering muncul adalah batuk (22,5%), demam (14,3%),sesak napas (6,5%), nyeri tenggorok (5,3%) dan pilek (4,8%). Gambaran radiologis sebagian besar pasien normal (41,9%), sesuai pneumonia (31,5%) dan corakan meningkat (26,6%). Hasil pemeriksaan laboratorium didapatkan limfopenia (10,9%), trombositopenia (1,7%) dan peningkatan NLR (18,4%). Serologi SARS-CoV-2sebagian besar pasien reaktif (48,8%). Sebagian besar pasien dirawat ≥20 hari (63,9%), masa konversi ≥14 hari (52,5%) dan luaran akhir pasien sembuh (99,3%). Terdapat hubungan bermakna antara komorbid dengan lama rawat (p= 0,03) dan lama konversi (p= 0,03), status awal masuk RS dengan lama konversi (p= 0,00) dan lama rawat (p= 0,00). Kesimpulan: Proporsi pasien terkonfirmasi COVID-19 dari keseluruhan pasien yang dirawat sebesar 78,13%, sebagian besar laki-laki dan gambaran radiologis normal. Terdapat kenaikan NLR dan kebanyakan serologi SARS-CoV-2reaktif. Sebagian besar pasien yang dirawat kasus asimtomatik dan luaran akhir perawatannya sembuh.

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Background: Coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated from Wuhan, China since December 2019. Jakarta is among of the epicenter of COVID-19 pandemic in Indonesia. Research data on COVID-19 in Indonesia is still very limited while there is an urgent need of disease characterization from the perspective of clinical features, radiological finding, laboratory profile, and severity.

Methods: This retrospective cohort study involved 1070 patients treated at an emergency hospital in Jakarta, Indonesia. Patients were screened for their clinical symptoms, radiological finding, laboratory profile, including the SARS-CoV-2 immunoserology, and then proceed with the SARS-CoV-2 RT-PCR examination. The screening resulted in 836 patients were confirmed COVID-19, and 413 patients had a complete medical record to be further studied.

Results: The mild-moderate cases were dominated by males (55.4%) of age groups <60 years-old (91.8%). The mean age was 39.94±14.17 years-old. Most subjects presented without comorbidities, although hypertension was common (4.1%). Most subjects were asymptomatic (46%) followed by moderate case (31.5%), and mild case (22.5%). Symptoms were cough (22.5%), fever (14.3%), shortness of breath (6.5%), sore throat (5.3%), and runny nose (4.8%). Radiological findings were normal (41.9%), pneumonia (31.5%), and increased opacity (26.6%). Laboratory tests showed lymphopenia (10.9%), thrombocytopenia (1.7%), and increased NLR (18.4%). The SARS-CoV-2 immunoserology was mostly reactive (48.9%). Length of stay (LoS) was ≥20 days (63.9%), conversion period was ≥14 days (52.5%), and most were recovered (99.3%). There were correlations between existing comorbidities and LoS (p=0.03) and conversion time (p=0.03). There were correlations between initial condition during hospital admission with conversion time (p=0.00) and LoS (p=0.00).

Conclusion: The proportion of patients with COVID-19 confirmed from all patients treated was 78.13%, whom male, normal radiological finding, increased NLR, reactive SARS-CoV-2 immunoserology, and asymptomatic predominated. Most of the patients were moderate cases and well recovered."

"Coronavirus Disease 2019 (COVID-19) merupakan pandemi dengan morbiditas dan mortalitas yang tinggi. COVID-19 dapat mencetuskan badai sitokin, suatu reaksi hiperinflamasi yang menyebabkan acute respiratory distress syndrome dan kegagalan multiorgan. Zink dipertimbangkan sebagai terapi supportif pada COVID-19 karena memiliki potensi sebagai immunomodulator, antivirus serta antiinflamasi. Penelitian ini dilakukan untuk mengetahui hubungan kadar zink pada saat masuk perawatan dengan manifestasi derajat penyakit COVID-19 serta luaran buruk COVID-19. Derajat penyakitditentukan berdasarkan manifestasi klinis sesuai kriteria WHO saat masuk perawatan sedangkan luaran buruk bila subjek pernah dirawat di ruang intensif, menggunakan ventilator selama perawatan atau meninggal. Pada penelitian ini didapatkan total 87 kasus yang terbagi menjadi kelompok derajat tidak berat sebanyak 74 kasus dan kelompok derajat berat sebanyak 13 kasus. Berdasarkan luaran didapatkan kelompok luaran buruk sebanyak 22 kasus dan luaran baik 65 kasus. Rerata kadar zink lebih rendah padakelompok derajat berat dan kelompok luaran buruk. Ditemukan hubungan yang bermakna secara statistik pada rerata kadar zink dengan luaran COVID-19 sedangkan dengan derajat penyakit cenderung bermakna secara statistik. Kadar zink terhadap luaran burukCOVID-19 memiliki luas Area Under the Curve (AUC) 81,6%, dengan nilai titik potong kadar zink 56,05 ug/dL yang memiliki sensitivitas 77,3% dan spesifitas 73,8%. Pasien dengan kadar zink ≤56,05 ug/dL berisiko 8,79 kali lebih tinggi mengalami luaran buruk COVID-19 dibandingkan pasien dengan kadar zink >56,05 ug/dL setelah diadjust dengan usia, komorbid penyakit jantung, dan diabetes mellitus. Diperlukan penelitian lanjutan dengan jumlah sampel yang cukup untuk memperkuat hasil penelitian ini.

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Coronavirus Disease 2019 (COVID-19) is a pandemic with high morbidity and mortality. COVID-19 can trigger a cytokine storm, a hyperinflammatory reaction that causes acute respiratory distress syndrome and multiorgan failure. Zinc was considered as a supportive therapy for COVID-19 because it has potential as an immunomodulator, antiviral and anti-inflammatory. This study aims to analyze the association between zinc level at the time of admission on disease severity and poor outcome of COVID-19. Disease severity was determined based on clinical manifestations according to WHO criteria on admission, while poor outcome was defined as a history of intensive care unit stay, intubated during treatment or deceased. There were 87 subjects consist of 74 cases of non-severe group and 13 cases of severe group. As for the outcome, there were 22 cases of poor outcome and 65 cases of good outcome. The mean of zinc level was lower in severe and poor

outcome group. There was a significant association between zinc level and poor outcome, while disease severity tended to be statistically significant. An Area Under the Curve (AUC) of zinc level and COVID-19 poor outcome was 81,6%, with a cut point of 56,05

ug/dL, sensitivity and specificity was 77.3% and 73.8%. Patients whose zinc level ≤56.05ug/dL had a 8.79-fold higher risk of poor outcome compared to patients whose zinc level > 56.05 ug/dL after age, heart disease, and diabetes mellitus adjustment. Further studies a sufficient number of sample are needed to support this study."

"Latar Belakang: Coronavirus disease 2019 (COVID-19) memiliki berbagai spektrum gejala klinis salah satunya sesak napas. Sesak napas disertai hipoksia merupakan prediktor penurunan kapasitas fungsional. Uji jalan 6 menit dapat mengidentifikasi sesak napas dan hipoksia pasca-uji latih pada pasien COVID-19 saat perawatan dan pascarawat. Penelitian ini bertujuan untuk mengetahui derajat sesak pada pasien COVID-19 yang dirawat dan pascarawat Metode: Penelitian ini merupakan penelitian kohort prospektif yang dilakukan pada Bangsal COVID-19 dan poli paru RSUP Persahabatan dari Agustus 2021 – Juni 2022. Subjek penelitian adalah pasien COVID-19 derajat ringan atau sedang yang dirawat di Bangsal COVID-19 yang memenuhi kriteria penelitian. Subjek penelitian akan dilakukan uji jalan 6 menit, penilaian skala Borg, saturasi oksigen, skor RALE dan arus puncak ekspirasi saat perawatan dan akan di evaluasi pada 1 bulan dan 3 bulan pascarawat. Hasil: Pada penelitian ini didapatkan 40 subjek penelitian. Nilai rerata uji jalan 6 menit pasien COVID-19 yang dirawat 279,9 m (SB ± 75,4), 1 bulan pascarawat 332 m ((SB ± 63,7) dan 3 bulan pascarawat 394,52 m (SB ± 58). Median saturasi oksigen pasien COVID-19 yang dirawat 97%, 1 bulan pascarawat 97,5% dan 3 bulan pascarawat 98%. Nilai median skala Borg pasien COVID-19 yang dirawat 2, 1 bulan pascarawat 1, 3 bulan pascarawat 1. Arus puncak ekspirasi pasien COVID-19 250 L/menit, 1 bulan pascarawat 310 L/menit dan 3 bulam pascarawat 370 L/menit. Median skor RALE pasien COVID-19 yang dirawat 3, 1 bulan pascarawat 2,5 dan 3 bulan pascarawat 1,5. Terdapat korelasi bermakna skala Borg dengan uji jalan 6 menit, saturasi oksigen dengan uji jalan 6 menit dan uji jalan 6 menit dengan skor RALE, terdapat korelasi bermakna arus puncak ekspirasi dengan skala Borg pada pasien COVID-19 yang dirawat dan 1 bulan pascarawat, terdapat korelasi bermakna saturasi oksigen dengan skala Borg pada pasien COVID-19 yang dirawat dan 1 bulan pascarawat Kesimpulan: Terdapat perbaikan derajat sesak yang ditunjukkan dari hasil uji jalan 6 menit, skala Borg, saturasi oksigen, skor RALE dan arus puncak ekspirasi pada pasien COVID-19 ringan dan sedang yang dirawat dibandingkan 1 bulan pascarawat dan 3 bulan pascarawat.

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Background: Coronavirus disease 2019 (COVID-19) has various clinical symptoms, one of which is shortness of breath. Exertional dyspnea is a predictor of decreased functional capacity. The 6-minute walk test can identify exertional dyspnea and hypoxia in COVID-19 patients during hospitalization and post-hospitalization. This study aims to determine the degree of shortness of breath in hospitalized and post-hospitalized COVID-19 patients. Methods: A prospective cohort study was conducted in the COVID-19 isolation ward and pulmonology clinic National Respiratory Center Persahabatan Hospital from August 2021 – June 2022. The study subjects were mild or moderate COVID-19 patients admitted to the COVID-19 isolation ward who met the research criteria. Patients underwent a 6-minute walk test, assessment of Borg scale, oxygen saturation, RALE score, and peak expiratory flow rate and will be evaluated at a month and three months post-hospitalization. Results: There were 40 subjects participating in this study. The mean of the 6-minute walk test of COVID-19 patients was 279.9 m (SD ± 75.4), one-month post-hospitalized was 332 m (SD ± 63.7) and three months post-hospitalized was 394.52 m (SD±58) Median oxygen saturation of COVID-19 patients was 97%, one-month post-hospitalized was 97.5% and three months post-hospitalized was 98%. Median Borg scale of COVID-19 patients was 2, 1-month post-hospitalized was 1, 3 months post-hospitalized was 1. The median peak expiratory flow rate of COVID-19 patients was 250 L/min, one-month post-hospitalized was 310 L/min and three months post-hospitalized was 370 L/min. Median RALE scores for COVID-19 patients was 3, 1-month post-hospitalized was 2,5 and 3 months post-hospitalized was 1,5. There was a significant correlation between Borg scale and 6-minute walk test, oxygen saturation with the 6-minute walk test and the 6-minute walk test with RALE score. There was a significant correlation between peak expiratory flow and the Borg scale in hospitalized and one-month post-hospitalized COVID-19 patients. There was a significant correlation between oxygen saturation with the Borg scale in COVID-19 patients and one-month post-hospitalized COVID-19 patients. Conclusion: There was an improvement in the degree of dyspnea in mild and moderate COVID-19 patients as indicated by 6-minute walk test distance, Borg scale, oxygen saturation, RALE score and peak expiratory flow rate compared to a-month and three-months post-hospitalized."

"Essentials of Medical Biochemistry: With Clinical Cases encompasses the fundamental biochemical topics that relate to health and disease, and epitomizes a broad understanding of the mechanisms underlying numerous health problems. An extensive review and reference guide for students and experts alike, Essentials of Medical Biochemistry includes four-color illustrations throughout for the best visual representation of events and processes that occur at the molecular level of physiologic regulations, clinical effects, and interactions. --Useful for students in biochemistry, medicine, and other healthcare disciplines as a refresher to meet USMLE and other professional licensing examination requirements, as well as for experts in the field of basic research, Essentials of Medical Biochemistry includes clinical case studies and offers added study materials on an accompanying website, including interactive multiple-choice questions and supplementary information, to help users best understand the diagnosis, therapy, and monitoring of human diseases. --Book Jacket."