Search

Cardiovascular disease (CVD) complication is common among chronic kidney disease (CKD) patients. Thus, knowledge about CVD and ECG abnormalities in CKD are essential due to progressive nature of the disease and increased risk of sudden cardiac death. This study aims to scrutinize the ECG abnormalities among nondialysis late-stage CKD patients. A descriptive observational study was conducted at Dr. Soetomo General Hospital, Surabaya, Indonesia. Subjects were hospitalized patients with late-stage CKD between 1 January and 31 December 2019, who were consulted at the department of cardiology and vascular medicine during their initial admission at emergency room. ECG interpretation for this study was done by qualified cardiologist. There were 191 patients included in this study. Mean ages were 52.2 ± 11.8 years old and 51% were males. Total 143 (74.9%) patients had anemia, 111 (58.1%) had hypertension and 75 (39.3%) had type 2 diabetes mellitus. Mean serum creatinine was 10.5 ± 8.0 mg/dL. There were 176 (92.1%) patients with at least one form of ECG abnormalities. Prolonged QTc interval (36.6%), fragmented QRS complex (29.8%), poor R wave progression (24.6%), peaked T wave (22.0%) and left ventricular hypertrophy (16.7%) were the most common abnormalities. ECG abnormalities are common among nondialysis late-stage CKD patients. Given the fact that long-term CKD influences the pathogenesis cardiovascular diseases and substantial cardiovascular mortality, there is a need to screen Indonesian CKD patients who are at risks of getting earlier complications. [ABSTRACT FROM AUTHOR]

Introduction: Pre-eclampsia is one of the most common causes of fetomaternal morbidity and mortality worldwide. This disorder is categorised into Early Onset Pre-eclampsia (EOPE) and Late-Onset Pre-eclampsia (LOPE). EOPE is usually accompanied by severe complications for both the mother and fetus, while LOPE is accompanied by relatively mild fetomaternal complications. Although the pathogenesis of EOPE is not yet fully elucidated, recent studies indicate that serum calcium and 25 Hydroxy Vitamin D (25(OH)D) levels may play a role in its pathogenesis. Aim: To find out the relationship of calcium and 25(OH)D serum levels in pregnant women with normal pregnancy and with EOPE in Indonesia. Materials and Methods: This study was a case-control study, conducted in Dr. Soetomo General Hospital from July to October 2017. A total of 36 women with EOPE and 64 women with normal pregnancy were included in this study. Inclusion criteria were pregnant women in 2nd or 3rd-trimester with BMI >18 kg/m2. Blood sample analysis was done to measure serum calcium and 25(OH)D level. Data were expressed as Mean±Standard Deviation. Data distribution was analysed using Shappiro-Wilk test. Comparison of serum calcium and 25(OH)D level between groups was analysed using Independent t-test. Correlation between serum calcium and 25(OH)D level was analysed using Pearson's correlation test. The p-value of <0.05 was considered significant. Results: There was a significant difference in serum calcium level between case and control group (8.294±0.725 vs 8.670±0.405 mg/dL; p=0.006). In 25(OH)D level, there was no difference between both groups (16.128±7.5463 vs 17.325±6.4992 ng/mL; p=0.406). No correlation was found between calcium and 25(OH)D level (r=0.165; p=0.101). Conclusion: Calcium deficiency plays a role in the incidence of EOPE among pregnant women in Indonesia. The actual role of calcium deficiency in EOPE needs further investigation. [ABSTRACT FROM AUTHOR]

Background: Until now, the cost of allergy treatment in the insured public health care system and the non-insured self-financing private health care system in Indonesia has not been well documented and published, as well as the cost of allergy treatment with subcutaneous immunotherapy. Objective: To evaluate the clinical and cost benefits of allergic rhinitis treatment in children with subcutaneous immunotherapy in a non-insured self-financing private health care system. Methods: A retrospective cohort study conducted from 2015 until 2020 that compared the clinical improvement and health care costs over 18 months in newly diagnosed AR children who received SCIT versus matched AR control subjects who did not receive SCIT, with each group consisting of 1098 subjects. Results: A decrease in sp-HDM-IgE level (kU/mL) from 20.5 + 8.75 kU/mL to 12.1 + 3.07 kU/mL was observed in the SCIT group. To reduce the symptom score of allergic rhinitis by 1.0 with SCIT, it costs IDR 21,753,062.7 per child, and for non-SCIT, it costs IDR 104,147,878.0 per child. Meanwhile, to reduce the medication score (MS) by 1.0 with SCIT, it costs IDR 17,024,138.8, while with non-SCIT, it costs IDR 104,147,878.0. Meanwhile, to lower combination symptoms and medication score (CSMS) by 1.0, with SCIT, it costs IDR 9,550,126.6, while with non-SCIT, it costs IDR 52,073,938.9. Conclusions: In conclusion, this first Indonesia-based study demonstrates substantial health care cost savings associated with SCIT for children with AR in an uninsured private health care system and provides strong evidence for the clinical benefits and cost-savings benefits of AR treatment in children. [ABSTRACT FROM AUTHOR]