The cut-off point of interleukin-6 level in acute coronary syndrome.

AIM: this study aimed to observe whether the interleukin-6 level in acute coronary syndrome (ACS) patients were higher than those in coronary heart disease (CHD) patients. In addition, we would like to observe the cut off point of interleukin-6 level in ACS. METHODS: this cross sectional study were conducted at Dr. Cipto Mangunkusumo General Hospital (RSUPN-CM), Persahabatan Hospital, MMC Hospital and Medistra Hospital, Jakarta. The study started from 1 May 2005 to 5 May 2006. RESULTS: in this observational study, as many as 62 CHD patients were collected and 84 ACS that met the study criteria. Demographic analysis showed that there was no difference in ages among the two groups (ACS and CHD). The risk factors of dyslipidemia, hypertension and lipid profile in the two groups did not differ significantly. Waist circumference and IMT, systolic and diastolic blood pressures in the two groups did not also differ significantly. Smoking was more prevalent in the groups of ACS than in the groups of CHD. In this study the IL-6 level in ACS (mean 40.85 pg/mL, SD 41.71, CI 95% 25.63-42.08 was higher than that in CHD (mean 4.58 pg/mL, SD 9.61, CI 95% 2.14-7.02). To identify the IL-6 level as the predictor for the occurrence of ACS, sensitivity and specificity were calculated at various cut-off points of IL-6 level. At cut-off point of IL-6 4.43 pg/mL the highest sensitivity (89.95%) and highest specificity (77.42%) were found with ROC of 0.87. CONCLUSION: it could be concluded that the IL-6 level in ACS were higher that those in CHD. The IL-6 level 4,43 pg/mL could differentiate the acute condition (ACS) and stable condition (non-ACS) with sensitivity of 89.95% and specificity of 77.42%, and ROC of 0.87.

The implementation of community participation in the control of malaria in rural Tanjung Pinang, Indonesia.

A study was undertaken to involve a hyperendemic community in Berakit village near Tanjung Pinang to participate actively in the control of malaria. Weekly chemoprophylaxis with chloroquine was given to all villagers of RK I with a population of about 700 for a period of one year. Nine cadres were selected from the community by the villagers for the distribution of the drug and coordinated by the head of the village. About 14-19 families were supervised by one cadre who was responsible for the weekly distribution of the drug to these families. The weekly dosage of the drug was adjusted according to age. The drug was taken in the presence of the cadres to assure the intake, and recorded by each cadre. The results showed that 93.7% of the villagers have taken the drug regularly. The remaining 6.3% of them showed refusal and irregular intake, or moved to another village during the period of prophylaxis. Although the drug has a bitter taste, most of the children were able to tolerate it. In general, mild side effects were reported and infrequently observed. Implementation of community participation to control malaria in this village showed good results which was reflected in the results of the malariometric surveys carried out before and after one year chemoprophylaxis. The spleen rate of about 600 villagers of RK I examined was 54.3% and the parasite rate 13.2% before the drug intervention. After one year chemoprophylaxis the spleen rate decreased to 21.7% and the parasite rate to 4.5% showing a significant difference.