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Abstract : The focus of this article is on the most important (prognostic and therapeutic) pregnancy related liver diseases: cholestasis of pregnancy, preeclampsia induced liver disfunction and intrahepatic cholestasis of pregnancy, eclampsia (including HELLP – hemolisys, elevated liver enzymes, low platelet count) and acute hepatic steatosis. They are completely reversible after delivery and must be distinguished from other intercurrent liver diseases, for which pregnancy is a possible precipitating factor. Intrahepatic (obstetric) cholestasis of pregnancy (ICP) is a unique hepatobiliary condition that manifests itself with itching, jaundice, an increase in the serum concentration of bile acids and poses a risk of complications for both the mother and the baby. ICP is a reversible type of hormonally influenced cholestasis. It develops during the third trimester, when hormone concentrations are at their peak. Ursodeoxycholic acid relieves pruritus and improves liver function tests in pregnant women in intrahepatic cholestasis and largely reduces fetal mortality, but has a secondary role in HELLP syndrome and acute hepatic steatosis during pregnancy, where timely delivery is the key to treatment.

Abstract : Human resources are one of the most vital elements in an organization. Similar to companies as organizations require employees who can work better and faster, thus employees who have maximum performance are required. Many factors influence the employee’s performance such as decreased commitment and job satisfaction. These problems can be mitigated in several ways such as by applying and encouraging spirituality in the workplace in particular by a leader. Based on this, researchers are interested in assessing whether there is an influence of workplace spirituality and spiritual leadership on the performance and job satisfaction of PT Bumi Jasa Utama Makassar employees. This research used a cross-sectional study design and was conducted in November 2022 with a sample of 50 employees. Data analysis used Path Analysis to see the direct effect as well as the influence moderated by the moderating variable (job satisfaction). Path analysis results show that spirituality in the workplace (p=0.040) and spiritual leadership (p=0.030) have a relationship or influence on employee performance. Path analysis results also conclude that job satisfaction as a moderating variable is capable of moderating the influence of workplace spirituality and spiritual leadership on employee performance (p<0.05). Activities are needed that improve the quality of relations between employees and leaders to create a good spiritual state to maximize employee performance.

Abstract : Acute variceal bleeding remains with a high mortality rate (around 15 %). Treatment is based on the combined use of vasoactive drugs, endoscopic band ligation and antibiotic therapy. Effective resuscitation (blood transfusions, volume replacement) is essential to prevent complications. In case of failure - transjugular intrahepatic portosystemic shunt (TIPS) with appropriate indications and limitations related to the prognosis of the individual patient. Balloon tamponade or specially designed coated esophageal stents can be used as a bridge to definitive therapy in unstable patients. Early TIPS should be the first choice in patients at high risk of treatment failure (Child-Pugh B with active bleeding or Child-Pugh C < 14). This article discusses the latest advances in variceal bleeding management in line with current recommendations of the Baveno VI Consensus Conference.

Abstract : The Coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome SARS-CoV-2 has challenged the health systems of countries affected by it. Covid-19 poses an important occupational health risk for health workers. Health workers are the front line in handling the Covid-19 outbreak putting them at risk of infection. This study aims to determine and analyze the risk of treatment for the incidence of Covid-19 in health workers. This research method used a Case Control Study design and was carried out at the Manembo-Nembo Hospital in Bitung, North Sulawesi Province. A sample of 96 people consisting of 48 cases and 48 controls. Sampling was purposive sampling, data collection techniques using questionnaires were applied using kobotoolbox software. Data analysis using the STATA 14 program. The results of the study a significant risk factor for the incidence of Covid-19 was a history of direct patient contact (OR=14.33 95%CI:4.4-53.2; p=0.000), face-to-face (OR=11,66 95%CI: 3.8-39.2; p=0.000), Direct contact with the environment where the patient is treated (OR= 4.42 95% CI: 1.73-11.4; p=0.000). Vaccination status (OR=2.04 95% CI: 0.10-123.06; p=0.557), Comorbid (OR=0.37 95% CI: 0.34-2.4; p=0.238), time of work (OR=0.89, 95% CI: 0.31- 1.53; p=0.811) not a risk factor. The most dominant factor at risk for the occurrence of Covid-19 is a history of direct contact with patients who have been confirmed to have had Covid-19. The high prevalence of health workers who have confirmed Covid-19 has a history of contact with patients with confirmed Covid-19.

Abstract : To assess the effect of administration of vitamin D3 tablet therapy on serum vitamin D 25-OH levels, hemoglobin levels, body mass index (BMI), and CD4/CD8 ratio in HIV/AIDS infected patients who have been treated with antiretrovirals (ARV). This study was a cross-sectional study using 40 samples of HIV patients who were routinely controlled at the VCT polyclinic at Dr. Moewardi who received regular antiretrovirals. The results of testing the mean difference between the two groups of serum levels of vitamin D 25-OH in the Vitamin D3 treatment and control groups showed a value of Z = -2.277 (p = 0.023). The results of the different test mean that the two groups of hemoglobin in the Vitamin D3 treatment group and the control showed a value of Z = -3.484 (p = 0.001). The results of different tests mean that the two BMI groups in the Vitamin D3 treatment group and the control group show a value of t = -5.098 (p = 0.001). The results of the mean difference test of the two CD4/CD8 ratio groups in the Vitamin D3 treatment group and the control group showed a value of t = -6.203 (p = 0.001). Administration of 2000 IU vitamin D3 tablets can increase serum vitamin D 25-OH levels, hemoglobin, BMI, and CD4/CD8 ratio in HIV/AIDS infected patients who have been treated with antiretroviral (ARV).