European Journal of Molecular & Clinical Medicine

Background of study: Hyperglycemia often occurs in critically ill patients even without a history of diabetes. Hyperglycemia, in hospital, according to the American Diabetes Association (ADA) is defined as a condition in which blood glucose levels are ≥140 mg/dl and HbA1c ≤6.5, without any prior diabetes history. Hyperglycemia results from an endocrine and metabolic response to stress. Studies and literature regarding hyperglycemia in non-diabetic patients in Indonesia are deemed limited, especially case studies of non-diabetic hyperglycemia in intensive care and the prevalence of hyperglycemia related to age, sex, metabolic risk (obesity, hypertension, dyslipidemia), history of parenteral nutrition, history of corticosteroids use, and disease diagnosis.
Methods: The present study is a retrospective descriptive study using medical record data of patients at the HCU, ICU, Brain Center, and CVCU PJT Wahidin Sudirohusodo Hospital in August 2020 - October 2020. This study involved 90 non-diabetic subjects in intensive care. The inclusion criteria were based on the ADA criteria for non-diabetic hyperglycemia in the hospital.
Results: This study involved 44 non-diabetic hyperglycemic patients and 46 non-diabetic patients without hyperglycemia with a mean age of 53.5 years in non-diabetic hyperglycemic subjects and 57.7 years old in subjects without hyperglycemia. Non-diabetic hyperglycemia subjects with obesity (34.1%), hypertension (61.5%), and dyslipidemia (46.9%). Subjects with hyperglycemia with a history of corticosteroid use (95%). Based on the diagnosis of the disease when the subject was in intensive care, the subject with a diagnosis of CHD had hyperglycemia (36.8%), stroke with hyperglycemia (58.8%), and other diagnoses (infection, tumor, postoperative, and trauma) accompanied by hyperglycemia (57, 1%).

Background of the Study: Bacterial and Viral infections are often hard to be distinguished in daily clinical practice. Biological markers obtained from a routine examination play an important role to minimize time in providing diagnose and giving therapy. Recently, the use of Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) is greatly considered to differentiate types of infection found in the patients presenting with fever.
Method: This study uses prospective cohort study design and involves patients presenting with fever who are admitted to the ICU. The initial NLR, MLR, and PLR is examined and categorized into types of infection found. The ANOVA test and t-test are performed to find out the difference among study groups with the value of α = 0,05.
Result : This study involves 207 patients (92 male patients [44%]) presenting with fever with the average age of 45,6 ± 14,6 years old. The majority of cases (135 cases [66,5%]) in patients with fever results from bacterial infection; The study also finds 47 cases (34,8%) of typhoid fever and 30 cases (22,2%) of pulmonary tuberculosis. Dengue hemorrhagic fever (DHF) is the most commonly found viral infection with 52 cases (76,4%). The significant diagnose of bacterial infection shows higher value of NLR and MLR than that of viral infection (P < 0,001); Urinary tract infection has the highest value of NLR and MLR, amounting to 9,4 ± 3,6 and 0,23 ± 0,20, respectively. In general, the value of PLR is lower than that of viral infection (P < 0,001).
Conclusion: Neutrophil-lymphocyte ratio, MLR and PLR have benefit to predict diagnosis for the patients presenting with a fever. Bacterial infection is associated with the high value of NLR and MLR, and PLR generally has a lower value in viral infection cases.