The association of prostatic inflammation grade with prostate volume and Prostate-Specific Antigen (PSA) value in Benign Prostate Hyperplasia (BPH) patients at Wahidin Sudirohusodo Hospital, Makassar

Background: Prostate inflammation is commonly found in patients with benign prostate hyperplasia. On the histopathological examination, infiltration of the prostate gland's inflammatory cells was visible in chronic inflammation of the prostate. This study aims to determine prostate inflammation's association based on the histological examination with prostate volume and prostate-specific antigen (PSA) levels in benign prostate hyperplasia (BPH) patients.

Methods: A cross-sectional study was enrolled among 50 subjects with benign prostate enlargement observed at Wahidin Sudirohusodo hospital and its affiliate Hospitals in Indonesia from April to September 2018. The patients' data, including age, prostate volume, PSA level, and histopathology, were collected. Statistical tests using Chi-square were performed (considered significant if P <0.05). Data were analyzed using SPSS version 17 for Windows.

Results: Among 50 subjects, the age ranged from 51 to 85 years, with an average of 68.2 ± 8.9 years, while the prostate volume average remained at 64.2 ± 31.4 mm³.  The average of the prostate-specific antigen (PSA) grade was 21.0 ± 30.2 ng/ml. The statistical analysis showed the association of age with the degree of inflammation (P = 0.25), the relationship of the prostate volume of the degree of inflammation (P = 0.46) and the value of PSA (P = 0.74). Among the 50 subjects examined, 100% were inflamed. The highest grade of inflammation was a moderate degree by 19 cases (38%). There is no significant relationship between the degree of inflammation with prostate volume and PSA's value (p>0.05). Besides, there is no significant association between the degree of prostate inflammation with prostate volume and the value PSA levels (p>0.05).

Significance of pulmonary hypertension probability in predicting six-minute walking distance in uncorrected acyanotic grown-up congenital heart disease at Sanglah General Hospital, Bali

Background: Pulmonary hypertension may cause impairment of functional capacity, which is a predictor of survival and quality of life in a patient with uncorrected acyanotic grown-up congenital heart disease. A six-minute walking test (6MWT) is a submaximal exercise test to measure these patients' functional capacity. This study aims to determine the significance of echocardiography parameters, such as Pulmonary Hypertension (PH) probability and Mean Pulmonary Artery Pressure (MPAP), as a predictor of functional capacity by 6MWT measurement.

Methods: Analytic observational study was used to determined walking distance as a measurement of functional capacity in acyanotic CHD patients. The probability of (PH) and MPAP was obtained from echocardiography and divided into three categories (low, intermediate, and high probability) based on guidelines defined by PH 2015. MPAP measured the d using the pulmonary valve acceleration time formula (90 – 0.62*PVAT). The relationship between 6MWT distance with MPAP and probability of PH was measured using pearson correlation and one-way ANOVA.  We included 43 patients from the Grown-Up Congenital Heart Disease (GUCH) registry who fulfills the inclusion criteria (age more than 18 years whom defect correction has not been done). All participants were given informed consent. Data were analyzed using SPSS version 20 for Windows.

Results: Forty-three patients were included in this study, with 35 females (81.4%) and 8 males with age range 18-75 years old. The most prevalent GUCH was an atrial septal defect (69.8%). Twenty-one (48%) patient was classified as high PH probability. There was a significant difference between the mild probability of PH with intermediate (MD=94.3 meters; p < 0.001) and high probability (MD=141.9 meters; p<0.001). MPAP shows a strong correlation with walking distance (r=-0.68; p<0.001).

The relationship between body height and weight toward blood hemoglobin level in the teen athletes

Background: Performance sports are carried out with high intensity and require excellent physical preparedness. This study aims to determine the relationship between height, weight, and athlete's blood hemoglobin level.

Methods: This research was an analytic observational type with a cross-sectional study design among 49 male and female athletes enrolled with the total sampling technique. Data were analyzed with a descriptive test, and normality test, and multiple correlations. A significance value of p ≤ 0.05 and research data was analyzed using software SPSS version 20 for Windows.

Results: Most respondents in both genders were normal in BMI (85.72%). However, anemia status tends to be higher in males (23.33%) than females (10.52%). The multiple correlation tests showed a moderate level of correlation with a value of r=0.408_. The significance analysis of the value of p=0.015 indicatesthat there is a significant correlation between Height, Weight, and Blood Hemoglobin (Hb) level (p<0.05).

Conclusion: There is a significant moderate positive correlation between height and weight to blood hemoglobin level.

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Grading of lymphocyte infiltrating tumor can be used as a prognosis factor compared to T Pathology and N Pathology on recurrency of colon cancer

Background: 30-50% of colon cancer patients will experience recurrence and then die. Several factors that can be used as a prognosis for recurrence are tumor staging, number of lymph nodes resected, high pT, and grading of TILs as an immune response that is useful for suppressing tumor growth. This study aimed to determine whether the TILs grading can be used as a prognostic factor for recurrence than pT and pN.

Methods: This study used a descriptive retrospective study with all colon cancer patients who had hemicolectomy R0 right and left and patients who had received chemotherapy folfox who experienced recurrence at Dr. Soetomo Surabaya. Data were analyzed using SPSS version 25.0 for Windows.

Results: It was found that 33 people (32.4%) experienced a recurrence of less than 2 years and 69 people (67.9%) experienced a recurrence of 2-5 years. Low-grade TILs were 37 people (32.4%), and high TILs were 65 (63.7%). Patients with low-grade TILs at most 21 people (56.7%) will experience a recurrence of less than 2 years, while patients with high-grade TILs at most 53 people (81.5%) will experience a recurrence in years 2 - 5. pT4 has a recurrence of less than 2 years as many as 6 people (46.2%), less than pT4 with a recurrence of 2-5 years, namely 7 people (58.3%) while pT3 who experienced a recurrence of less than 2 years, the number was higher than pT4, namely 22 people (32.8%). pN0 will experience the highest recurrence in years 2-5 as many as 37 people (80.4%), while pN2 will experience the highest recurrence in less than 2 years as many as 14 people (66.6%). Grading TILs were significant (p = 0.018) in determining the prognosis than pT (p = 0.204) and pN (p = 0.083) in the first 2 years.

Conclusion: Grading of TILs can be a prognostic factor for colon cancer recurrence in only the first 2 years.

Nitrogen balance for estimating protein requirements in critically ill patients: a literature review

In critically ill patients, marked protein catabolism is prevalent. Protein demanding for such patients has been based on commending nitrogen balance, in most cases. Due to the stress response, critically ill patients tend to fall into a negative nitrogen balance state. Metabolic changes, particularly in elderly critically ill patients, increase the risk of the worsening nitrogen balance. Some evidence suggested optimal nitrogen balance may not indeed equalize to the best clinical outcome. On the contrary, several studies reported the available nitrogen balance data in establishing new recommendations for the protein required by critically ill patients. There is a hypothesis that adequate protein supplementation utilizing nitrogen balance could be correlated with improved results for patients in intensive care unit (ICU). Therefore, this literature review aims to deliver a brief explanation of whether nitrogen balance can be useful in documenting the effectiveness of nutritional therapy in critical illness or not.