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Broken Heart Syndrome (BHS) is the weakness of the heart muscle due to emotional stress or physical stress called cardiomyopathy. The main etiology is a sudden release of stress hormones (catecholamines), such as norepinephrine, epinephrine, and dopamine. About 90% of BHS patients are female with average age of 67-70"‰ years, most of them are post-menopausal females. The most widely supported pathological theories are catecholamine-induced cardiotoxicity and microvascular dysfunction. The clinical condition resembles that of acute myocardial infarction, consisting of chest pain, electrocardiographic changes, elevated cardiac biomarkers, and abnormalities of heart wall motion. There is transient systolic dysfunction in the apical and/or middle segment of the left ventricle resembling acute myocardial infarction but absence of coronary artery obstructive disease. There are BHS criteria according to Mayo Clinic. Laboratory tests can be performed by examining Natriuretic Peptides, cardio myonecrosis markers (Troponin I and T, creatinine kinase, and myoglobin), and catecholamines. There is no single established biomarker for initial diagnosis of BHS that distinguishes it from STEMI. It was found that the most accurate ratio as a marker capable of differentiating BHS from STEMI in early stages was NTproBNP/TnI ratio. The InterTAK diagnostic score was used to predict the probability of BHS, differentiating it from ACS in an acute stage, prior to coronary angiography. The main differential diagnosis of BHS is ACS, besides acute myocarditis infectious. Patients with BHS should be treated as ACS until proven otherwise. The prognosis for BHS patients is generally very good.

The limitations of health facilities in diagnosing AMI, especially in remote areas require an easy and inexpensive examination such as Neutrophil Lymphocyte Ratio (NLR) and High-Density Lipoprotein (HDL), which have a positive correlation with hs-Troponin I. The purpose of this study was to analyze the value of NLR, HDL, and hs-Troponin I as diagnostic markers in STEMI and NSTEMI patients. This retrospective study used medical record data for 152 STEMI patients and 93 NSTEMI patients from January to December 2020 at Dr. Wahidin Sudirohusodo. The NLR value was based on the results of routine blood tests using Sysmex XN-10, the results of HDL examinations using the Bio Majesty JCA-BM9010/c instrument, and the results of the hs-Troponin I examination using the Vidas instrument. Statistical tests using the MannWhitney test, the diagnostic value of NLR, and hs-Troponin I was analyzed by ROC to obtain the cut-off. The test result is significant if p

Acute Myocardial Infarct (AMI) is the main reason for mortality. Platelet to Lymphocyte Ratio (PLR) describesthrombocyte aggregation and inflammation that is linked to cardiovascular disease. High-Density Lipoprotein (HDL) is antiatherogenic.This study aims to analyze the prognostic value of PLR and HDL in patients with AMI. This study was aretrospective observational study by obtaining laboratory results from complete blood count and lipid profiles frominpatients with AMI (STEMI and NSTEMI) medical records during Mei 2019–August 2020. Receiver Operating Characteristics(ROC) analysis was done to get the PLR and HDL cut-off. Prognostic value evaluation was based on sensitivity, specificity,positive and negative predictive value, and accuracy. Results obtained were from 302 subjects with a mean age of 58.4+9.6years old, with most male patients (74.5%). Receiver operating characteristics curve analysis showed an 0.514 Area UnderCurve (AUC) for PLR with p=0.685. High-density lipoprotein ROC was 0.573 with a p=0.033 (p< 0.05), with HDL cut-off = 50.0;sensitivity 72.7%, specificity 32.3%, positive predictive value 63.3%, negative predictive value 42.0% and 57.3% accuracy.Platelet to lymphocyte ratio mean was lower in the HDL 50 (210.8), (p=0.009).High-density lipoprotein can be concluded as a potential prognostic factor of acute myocardial infarct. The lower the HDL,the greater the risk for a poor prognosis. A big-scale prospective study should be held to clarify and confirm these findings.

Chronic Kidney Disease (CKD) is defined as a renal failure that has lasted for more than three months. Hemodialysis is thetype of kidney replacement therapy that is mostly used, and blood gas analysis can be used to identify this condition. Thisstudy is to compare the blood gas analysis on pre-and post-dialysis in patients with CKD using pH, PaCO , PaO , HCO , SO , 2 2 3 2and BE as markers of improvement in the patients'condition. The population was all patients diagnosed with CKD andhemodialysis at Wahidin Sudirohusodo Hospital, and eligible according to the criteria in this study. The sample size wasdetermined using Federer's calculation, and the statistical analysis using paired T-test and Wilcoxon signed-rank test withα=0.05. Subjects were 34 patients, consisting of 18 females (52.9%) and 16 males (47.1%). Hemodialysis had the mostsignificant impact on the PaO and SaO variables. Relation between PaO and SaO was illustrated in a sigmoid curve. 2 2 2 2Oxygen-bound hemoglobin increased after the first molecule was bound. An almost full PaO pressure will cause a slight 2increase in SaO . Whereas at

Acute Kidney Injury (AKI) remains a common complication of post-operative Coronary Artery Bypass Grafting (CABG)related to high morbidity and mortality. Systemic inflammation has been known as a part of the pathogenesis of acute kidneyinjury. This study aimed to analyze the Neutrophil Lymphocyte (N/L) ratio and Platelet Lymphocyte (P/L) ratio in post-operativeAKI. This research was a retrospective study involving 76 patients who underwent CABG surgery in Dr. Wahidin SudirohusodoCentral Hospital, Makassar, between January 2015 and May 2019. The diagnosis of AKI was based on Kidney Disease ImprovingGlobal Outcomes (KDIGO) 2012 criteria. The N/L ratio and P/L ratio were calculated respectively as a neutrophil count ratio tolymphocyte count and platelet count to lymphocyte count. Twenty-five (32.9%) patients developed AKI in the first 48 hours ofthe post-operative period. There was no difference in pre-operative N/L ratio and the P/L ratio between AKI and non-AKIgroups (p > 0.05). Both ratios increased after surgery and were significantly different between the two groups with higher meanratio in non-AKI (16.93±9.16 vs. 21.86±11.13, p=0.040 and 239,24±184,36 vs. 314,49±143,73, p=0.011). Both pre-operativeand post-operative N/L ratio and P/L ratio could not distinguish AKI after CABG.

Background: Heart disease is one of the highest mortality diseases and 30% is caused by acute myocardial infarction (AMI). Kidney disease is one of the complications that occurred in patients with acute myocardial infarction. Several previous studies have reported a high incidence of Acute Kidney Injury (AKI) in patients with AMI (10-27%); the incidence is more elevated when accompanied by cardiogenic shock (50%). Serum BUN and creatinine tests are used to monitor the course and prognosis of renal disorder. This study aims to analyze the BUN/creatinine ratio in IMA patients.Methods: A retrospective cohort study by taking secondary data from medical records in 80 AMI patients (STEMI and NSTEMI) at Dr. Wahidin Sudirohusodo Hospital, Makassar, for January 2017-December 2018. The variables assessed in this study were age, gender, diagnosis, history of the disease, BUN, creatinine, and BUN/creatinine ratio. Data were analyzed using SPSS version 17 for Windows.Results: There was a significant difference between the first examination of ureum (p

Hyperbilirubinemia is one of the most common clinical phenomena in neonatal patient. Etiology is generally physiological, only about 10% being pathological. It is important for clinicians to distinguish between physiological and pathological hyperbilirubinemia, because uncontrolled pathological conditions can cause severe complications of kern icterus, one ofthe causes of death in infants.This study was retrospective study by obtaining data of all neonatal patients with diagnosis of hyperbilirubinemia, who undergone hemoglobin and leukocyte count test. The data were classified into two groups: physiological and pathological hyperbilirubinemia. Statistical tests were performed to assess the association of hemoglobin levels and leukocytes count between the two groups. A total of 144 data were collected, 54 physiological and 90 pathological hyperbilirubinemia. In physiological hyperbilirubinemia, hemoglobin levels and leukocyte counts were found to be normal, whereas in pathological anemia and leukocytosis developed and the difference between the two groups was statistically significant (p

Pleural effusion is a fluid excess into pleural cavity due to transudation or exudation processes. The fluid deposited in the cavity canthreat the patient's life. The pleural effusion could be produced in a patient with tuberculosis, cancer, cardiac failure, renal failure orviral/bacterial infection. The study is aimed to analyze the patterns of substance in the pleural effusion fluids produced by differentdiseases. A cross sectional study was performed from June 2006 to June 2007 at Clinical Pathology Laboratory of Dr. WahidinSudirohusodo Hospital, Makassar. The fluids were tested for glucose, total protein, LDH, and leukocyte count. Of 87 pleural effusion fluidsamples from 14–80 years old patients, 34.5% were transudates and 65.5% were exudates. Glucose value was higher (one tail T test,p < 0.01) in transudates group, whereas protein, LDH and leukocyte count were higher (one tail T test, p < 0.01) in exudates group.There were no significant differences of glucose, protein, LDH and leukocyte count among diseases within transudates group, as well aswithin exudates group. Staphylococcus spp., Klebsiella spp., and Acinetobacter spp., were the predominant bacteria revealed from thefluid cultures. Values of glucose, protein, LDH and leukocyte count have a different pattern between transudates and exudates groups.However, no special patterns were found among diseases within groups.

Acute Interstitial Nephritis (AIN) is the main cause of acute renal failure because of hypersensitivity to many antibiotics and otherdrugs that potent to induce allergic response in renal interstitial tissue. Gold standard for AIN diagnosis upheld from clinical sign,laboratory, USG, Gallium renal tests and renal biopsy. A cross sectional study was carried out among 120 (AIN) patients and none (AIN)from the Paediatrics and Internal Medicine Department Wahidin Sudirohusodo hospital from June until September 2008. Eosinophilcount was performed using haematology auto analyser. The data was analyzed by Mann-Whitney test using SPPS for windows. Thetotal 120 samples consisted of 60 samples of AIN and 60 samples Non AIN were included in this study. Mean eosinophil in AIN 4. 9 %and non AIN 3. 1%. There were statistical difference of eosinophil level between AIN and non AIN with p < 0. 00. Eosinophil level canbe used to differentiated between AIN and non AIN in conjunction to the clinical sign.

Background: Atherosclerosis in CAD is marked by formation of plaque inside the arterial lumen. Platelet plays a role on formation and development of atherosclerosis. Adhesion of platelets to the endothelial cells followed by releasing platelet granules caused inflammation of endothel. Lymphocytes also play a role in atherosclerosis and atherotrombosis. T lymphocyte was the first to be recruited inside atheromas and gathered along inside an unstable plaque. The severity of stenosis can be calculated using Gensini score. The Aim of this study is to analyze the correlation between PLR and degree of stenosis in CAD.Methods. This study is a retrospective study by collected 110 patients with CAD that had undergone coronary Angiography. Platelets and lymphocyte count were measured by automatic haematologycal analyzer. PLR was measured by dividing trombocyte count with absolute lymphocyte. Angiography findings were calculated using Gensini score and later devided into 3 groups according to degree of severity.Results. 110 patients retrospectively assesed, 80% were male and 20% female. The most age found was 50-59 years (35.5%). Using Anova test there is a significant differences on PLR between 3 groups of lesions (p

Ischemic stroke is the cause of most cases which occur due to obstruction, this pathogenesis can be caused by the formation of thrombus in the cerebrum blood vessels. Platelet aggregation plays a role in the pathogenesis of thromboembolic cerebrovascular disease. Platelets size, measured as Mean Platelet Volume (MPV) is a marker of platelet function and is associated with the indicator of platelet activity. Several studies have found that there was an increased of MPV in acute ischemic stroke while the correlation with the severity and outcome of stroke was still controversial. The aim of study is to determine the MPV and their association with outcomes in acute ischemic stroke patients. A cohort study during May up to July 2010 was carried out, the researchers measured MPV and analyze their correlation with its outcome using modified Rankin scale score 10 days after the onset in 33 acute ischemic stroke patients. The mean of MPV for the first three days of the onset was 8.9 fl, on the 5th day was increased up to 9.4 but at the 10th day of onset the MPV remains the same value as the 5th day. The MPV of first three days and 5th day have a positive correlation, but insignificant with their outcome, with p values 0.158 and 0.06, respectively. From this study can be concluded that the increased of MPV on the fifth day onset did not have any significant correlation with the outcome of acute ischemic stroke illness. Strok akibat iskemik merupakan penyebab sebagian besar kasus yang terjadi karena penyumbatan yang dapat disebabkan oleh darah beku (trombus) yang terbentuk dalam pembuluh darah otak besar (serebrum). Agregasi trombosit berperan pada perjalanan penyakit tromboemboli serebrovaskular. Ukuran trombosit diukur Mean Platelet Volume (MPV) yang merupakan petanda fungsi trombosit dan berhubungan dengan penunjuk aktivitas trombosit. Di beberapa telitian ditemukan peningkatan MPV strok akibat iskemik akut, sedangkan pendapat hubungan dengan berat dan keluaran strok masih kontroversial. Tujuan penelitian ini adalah untuk mengetahui dan menentukan nilai MPV strok akibat iskemik akut dan menentukan hubungan MPV dengan keluaran di pasien yang mengidap strok akibat iskemik akut. Penelitian dilakukan secara sama ciri selama masa waktu Mei - Juli 2010, MPV diukur dan dianalisis hubungannya dengan keluaran menggunakan angka modified Rankin Scale 10 hari setelah awal penyakit di 33 pasien pengidap strok iskemik akut. Nilai rerata MPV pada tiga hari pertama awal penyakit adalah 8,9 fl, dan pada hari kelima meningkat menjadi 9,4, tetapi pada hari kesepuluh MPV tetap sama dengan awal penyakit hari kelima. MPV pada tiga hari pertama dan hari kelima dengan keluaran bernasab positif, tetapi tidak bermakna dengan nilai p masing-masing 0,158 dan 0,06. Didasari hasil telitian ini dapat disimpulkan bahwa MPV meningkat pada hari kelima awal penyakit, tetapi tidak berhubungan bermakna dengan keluaran strok akibat iskemik akut.