Health Issues Among Healthcare Workers During COVID-19 Pandemic: a Psychosomatic Approach.

Healthcare workers as the front-liner to fight COVID-19 pandemic, need reassurance of their safety. The stress and the demands from the healthcare system can affect their health as well as the morality. Hence, psychosomatic approach should be used to keep their condition in good shape. The combination between biological, psychological, and social approaches may affect their vulnerability from SARS-CoV-2 infection. The biological aspect includes personal protective equipment, nutrition, and resting/sleeping time. The psychological distress is shown to affect the immune system; and mental relaxation and management of work shift may reduce the distress. There should be an effort from the stakeholders to keep the morality of the healthcare workers. The social aspect such as providing place to live, having supportive family members, and avoiding stigmatization also improve their psychological health. In conclusion, psychosomatic approach is important to keep the healthcare workers healthy.

Adult-onset Still's Disease as a Differential Diagnosis in Prolonged Fever: Diagnosis and Treatment Experience.

Adult onset Still's disease is a rare systemic disease that may involve many organs and may mimick many disease such as infection, autoimmune disease, and also malignancy. The diagnostic approach and treatment strategies have not been well established due to its rarity; however, there are some diagnostic criteria that may help. We present a case of 36-year old man who experienced high prolonged fever which firstly thought as infection. He also had unilateral wrist and knee joint pain and maculopapular rash. Laboratory examination showed high leukocytes count with elevated polymorphonuclear neutrophil count, high platelet count, high ferritin level, and negative results of many infection markers (typhoid antibody, procalcitonin, malaria test, blood culture, urine culture, IgM pneumonia, ASTO, syphilis test, antiHIV, HBsAg, antiHCV, etc). Chest X-ray, joint X-ray, ultrasonography, and echocardiography showed normal result. The patient was then diagnosed with Adult-onset Still's disease and received intravenous methylprednisolone and the fever was disappeared in 3 days. Six months later the arthralgia appeared again, methotrexate was administered and the pain was then relieved.

Colloids Versus Albumin in Large Volume Paracentesis to Prevent Circulatory Dysfunction: Evidence-based Case Report.

Large volume paracentesis may cause paracentesis induced circulatory dysfunction (PICD). Albumin is recommended to prevent this abnormality. Meanwhile, the price of albumin is too expensive and there should be another alternative that may prevent PICD. This report aimed to compare albumin to colloids in preventing PICD. Search strategy was done using PubMed, Scopus, Proquest, dan Academic Health Complete from EBSCO with keywords of "ascites", "albumin", "colloid", "dextran", "hydroxyethyl starch", "gelatin", and "paracentesis induced circulatory dysfunction". Articles was limited to randomized clinical trial and meta-analysis with clinical question of "In hepatic cirrhotic patient undergone large volume paracentesis, whether colloids were similar to albumin to prevent PICD". We found one meta-analysis and four randomized clinical trials (RCT). A meta analysis showed that albumin was still superior of which odds ratio 0.34 (0.23-0.51). Three RCTs showed the same results and one RCT showed albumin was not superior than colloids. We conclude that colloids could not constitute albumin to prevent PICD, but colloids still have a role in patient who undergone paracentesis less than five liters.