Predictive biomarkers of preeclampsia severity in a low resource setting: Role of red blood cell indices, NLR, and albumin-to-creatinine ratio.

Preeclampsia (PE), a serious medical condition with substantial maternal and perinatal implications, poses a significant challenge, particularly in high-incidence countries like Indonesia. Red blood cell (RBC) indices, neutrophil-to-lymphocyte ratio (NLR), and microalbuminuria (albumin-to-creatinine ratio (ACR)) may signal systemic inflammation and endothelial dysfunction, recently recognized as potential indicators for diagnosing and predicting disease severity. The aim of this study was to analyze RBC indices, NLR, and ACR changes in women with PE and their potential for predicting disease severity. A cross-sectional study was conducted at multi-center hospitals across Medan, Indonesia, from June 2022 to June 2023. The patients were grouped into PE cases with and without severe features. Demographic characteristics and complications were recorded while blood and urine were tested. The Chi-squared test, Fisher's exact test and Mann-Whitney test were used to determine biomarkers associated with severe PE. A total of 208 PE patients were included in the study (104 patients for each PE with and without severe features). Our data indicated that PE patients with severe features had higher red cell distribution width (18.5% vs 13.7%; p<0.001), NLR (5.66% vs 4.1%; p<0.001), and ACR (755.97 mg/dL vs 468.63 mg/dL; p<0.001) compared to those without severe features. In contrast, the platelet count was lower in severe features than those without (21.9 × 106/µL vs 27.0 × 106/µL; p=0.002). This study highlighted that PE patients with severe features predominantly had higher levels of RDW, NLR, and ACR and lower platelet counts compared to those without severe features. Therefore, basic tests such as complete blood count and urinalysis, which are inexpensive and feasible in primary care settings with limited resources, offer hope as valuable diagnostic biomarkers for pregnant women diagnosed with PE in a low resource setting.

Accuracy and Pitfalls in the Smartphone-Based Audiometry Examination.

Introduction: Approximately 466 million people suffer from hearing loss worldwide, with Indonesia ranking fourth in Southeast Asia. However, conventional pure-tone audiometry is not yet available in many areas because of its high cost. Numerous available smartphone-based audiometry applications are potential alternative screening tools for hearing loss, especially in Indonesia. This study examined the findings on the validation of smartphone-based audiometry applications to assess hearing functions available in Indonesia. Materials and Methods: Based on the established eligibility criteria, this study was conducted by browsing the relevant literature validating smartphone-based audiometry applications in Indonesia. Relevant study data, such as the author, year, location, implementation procedures, and outcomes, were extracted and summarized. Results: This systematic review found 17 relevant and eligible publications. Of the six applications tested, 5 were found to have good validity, such as uHearTM, Audiogram MobileTM, AudCalTM, Hearing TestTM e-audiologia, and WuliraTM. All smartphone-based audiometry was tested only for the air conduction threshold and was influenced by several factors. Conclusion: Because smartphone-based audiometry is inexpensive, simple, and more accessible than conventional audiometric testing, it can be useful as a screening modality or alternative approach to assess hearing function. Unfortunately, smartphone-based audiometry cannot replace conventional audiometry in diagnosing hearing impairment.

Meiotic Spindle View improves the Outcome of IVF in Poor Responders: A Retrospective Analytical Study from an Indonesian IVF Center.

OBJECTIVE: Previous studies have shown that the meiotic spindle is not always aligned with the first polar body (PB) in metaphase II human oocytes. Polarized Light Microscopy (PLM) has been used to observe and locate the meiotic spindle to avoid disrupting it while injecting oocytes. The aim of this study is to evaluate the relationship between meiotic spindle view and IVF-ICSI outcomes in poor responder women. METHODS: This study was a retrospective analytical study, carried out from January to November 2019; involving 115 poor responder women who underwent IVF-ICSI cycles at the Halim Fertility Center, Indonesia. The patients were divided into two groups: group I without meiotic spindle viewing (non-MSV) as control group, and group II with meiotic spindle viewing (MSV) as the case group. The meiotic spindles were imaged before ICSI with Oosight microscopy. Baseline characteristics and IVF-ICSI outcomes of both groups were compared. RESULTS: Our study included 115 poor responder women with non-MSV group (71 women), and an MSV group (44 women). The results showed that there was no significant difference in the fertilization rate between the two groups (p>0.05), but the embryo cleavage rate was higher in the MSV group when compared to the non-MSV group; and there was a significant difference between the two groups (p<0.05). The fertilization rate was higher in aligned than misaligned spindle and there was a significant difference between the two groups (p<0.05). Good quality embryo was higher in MSV group than non-MSV group (59.05% vs. 63.95%). CONCLUSIONS: Meiotic spindle view might improve the outcome of IVF in poor responder women.

OVERVIEW OF COVID-19 CASES IN PREGNANCY AT THE HOSPITAL UNIVERSITAS SUMATERA UTARA, INDONESIA, WHEN THE PANDEMIC STORM HIT IN THE 2020-2022 PERIOD.

Background: COVID-19 (Coronavirus 2019) is caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2), an acute infectious disease primarily affecting the respiratory system. Data on COVID-19 exposure during pregnancy and issues associated with COVID-19 during pregnancy remain limited. This research aimed to determine the number of pregnant women infected by COVID-19, laboratory test findings of pregnant women related to COVID-19 infection, infant outcome from mother with or without COVID-19 infection and referential status for COVID-19 and non-COVID-19 pregnant women at the USU Hospital during the 2020-2022 period. Materials and Methods: This research was conducted using a descriptive method with a cross-sectional study approach using a non-probability sampling technique by collecting secondary data from COVID-19 and non-COVID-19 pregnant women at the USU Hospital during the 2020-2022 period, where 112 samples were obtained. Results: The majority of COVID-19 pregnant women and non-COVID-19 pregnant women have been identified sequentially based on Hb (11.6%-decreased vs 79.5%-normal); Ht (11.6%-decreased vs 76.8%-increased); leukocytes (11.6%-increased vs 83%-normal); thrombocytes (8.9%-normal vs 86.6%-normal); PT (9.8%-normal vs 50.9%-normal); APTT (11.6%-normal vs 87.5%-normal); D-dimer (11.6%-long vs 56.3%-long); procalcitonin (7.1%-increased vs 87.5%-normal); NLR (8%-increased vs 82.1%-normal); CRP (12.5%-increased vs 87.5%-normal) and all of the baby outcomes were non-COVID-19 and the majority of pregnant women were not referred. Conclusion: Based on the data in this study, the majority of pregnant women and babies at the USU Hospital during the 2020-2022 period were non-COVID-19 positive and with non-referral status. Laboratory findings of COVID-19 in pregnancy significantly reveals abnormalities.

Influence of Hormonal Changes on Audiologic Examination in Normal Ovarian Cycle Females: An Analytic Study

Abstract Introduction There is only limited information from previous studies that suggest that auditory function may be influenced by hormones. Recent advances in the field have exposed the potential role of hormones in modulating the auditory system. Objective This study aims to investigate the relationship between menstrual cycle and outer hair cell function with audiological examination. Methods This is an analytic study with a cross-sectional design. The sampling was a systematic random sampling. We found 49 women with normal menstrual cycle and collected their data through interviews, physical examination, and examination of the ear, with otoscopic and other routine otorhinolaryngology examinations. We evaluated Tympanometry, distortion-product otoacoustic emissions (DPOAE), and pure tone audiometry. Results We found the audiometric threshold worse in the follicular phase than other phases at 4000 Hz of the right ear, and in the ovulation was found best than any other phases at 1000 Hz of the left ear with significant difference. We found significant difference of DPOAE between ovulation time and follicular phase at 3000 Hz and 1000 Hz in the left ear and between ovulation and luteal phased at 2000 Hz, 3000 Hz and 5000 Hz in the right ear and at 1000 Hz in the left ear with p< 0.05. Conclusion The result of this study showed that only a small part of audiometry threshold had a significant difference between each menstrual phase. In other words, we found no correlation between menstrual and audiometry threshold. Nonetheless, there is a correlation between menstrual cycle phase and DPOAE amplitude.

Influence of Hormonal Changes on Audiologic Examination in Normal Ovarian Cycle Females: An Analytic Study.

Introduction There is only limited information from previous studies that suggest that auditory function may be influenced by hormones. Recent advances in the field have exposed the potential role of hormones in modulating the auditory system. Objective This study aims to investigate the relationship between menstrual cycle and outer hair cell function with audiological examination. Methods This is an analytic study with a cross-sectional design. The sampling was a systematic random sampling. We found 49 women with normal menstrual cycle and collected their data through interviews, physical examination, and examination of the ear, with otoscopic and other routine otorhinolaryngology examinations. We evaluated Tympanometry, distortion-product otoacoustic emissions (DPOAE), and pure tone audiometry. Results We found the audiometric threshold worse in the follicular phase than other phases at 4000 Hz of the right ear, and in the ovulation was found best than any other phases at 1000 Hz of the left ear with significant difference. We found significant difference of DPOAE between ovulation time and follicular phase at 3000 Hz and 1000 Hz in the left ear and between ovulation and luteal phased at 2000 Hz, 3000 Hz and 5000 Hz in the right ear and at 1000 Hz in the left ear with p < 0.05. Conclusion The result of this study showed that only a small part of audiometry threshold had a significant difference between each menstrual phase. In other words, we found no correlation between menstrual and audiometry threshold. Nonetheless, there is a correlation between menstrual cycle phase and DPOAE amplitude.