Optimal water intake for the elderly: prevention of hypotremia.

Aim The prevalence of hyponatremia in the elderly is quite high due to the rising of ADH and ANP concentrations which are part of eight physiologic changes. The complications are quite specific, among others, increased risk of bone fracture, declining of conciousness, and convulsion. The frequent cause of hyponatremia is high water intake. To achieve the optimal water intake designated as the highest water intake that did not cause hyponatremia and hypovolemia. Methods A study was conducted on 31 healthy elderly subjects, selected from 107 persons using simple random sampling and exclusion criteria. By block randomisation were classified into five water-intake groups (1000-2500 mL). Results In this study, it could be proved that 1000 mL was the optimal. It was also unraveled that the ADH levels had a role in determining the water intake volume that did not cause hyponatremia and NT-proBNP concentrations did not correlate with spot urine sodium. Conclusion The optimal water intake for the elderly is 1000 mL per day.

Proposed evaluation of laboratory performance in an external hematology quality control scheme.

The commercial control material for hematology Cell Dyn 16 Tri Level gave a good precision an accuracy using the four blood cell counters currently mostly used in Indonesia, the Coulter, Sysmex, Serono and Cell Dyn. It could be used as one of the hematology control material in an external quality control scheme. Result of the CV from participating laboratories are higher compared to this trial are caused by different level of laboratory technical ability although the geographical area and climate may also play a role. The new scoring calculation to evaluate the participant's performance gave a more wider range of DI scores, to give better insight to the performance of each laboratory.

Country report: the Indonesian NEQAS on hematology. National External Quality Assessment Scheme.

Around six hundred clinical laboratories in all the province of Indonesia participated the Indonesian National External Quality Assessment Scheme (NEQAS) on Hematology (Program Nasional Pemantapan Kualitas Laboratorium Klinik bidang Hematologi). Automated analyzer gave better results compared to the manual method. For hemoglobin, the CV of automated analyzer and manual method were 2.8% and 9.1%, respectively. The CV of automated analyzer and manual method for leukocyte count were 8.3% and 32.3%; for erythrocyte count were 9.7% and 80.8%; and for thrombocyte count were 10.3% and 45.9%. We observe no significant improvement of the overall performance from 1986 to 1998. Quality control material for NEQAS on hematology is still a problem. The artificial particles seem not behave exactly like the human cells (leukocytes, thrombocytes).

The effect of Norplant on some hemostatic parameters in Indonesian women.

Many reports have indicated that oral contraceptives can increase the incidence of thromboembolic disorders. Norplant, an implant contraceptive containing levonorgestrel, has been developed recently. The aim of this study is to observe the effect of Norplant on some hemostatic parameters. The subjects in this study were divided into 5 groups. Group 1 (control) consisted of 25 female blood donors. Group 2 (N = 25), group 3 (n = 25), group 4 (n = 17) and group 5 (N = 20) consisted of subjects who had been using Norplant for 2, 3, 4, and 5 years, respectively. Prothrombin time, activated partial thromboplastin time, fibrinogen level, assay of F VII and X, antithrombin III activity, plasminogen activity, alpha 2-plasmin inhibitor activity and platelet aggregation test were done in all subjects. Our results showed that there was a significant difference (p < 0.05) on platelet aggregation induced by 10 microM of ADP between the control group and Norplant users for more than 2 years, while the other parameters did not differ significantly. It is concluded that 5 years users of Norplant did not alter blood coagulability, but increased platelet response to 10 microM of ADP.

Investigation of coagulation abnormalities in patients with erythema nodosum leprosum.

Twenty erythema nodosum leprosum (ENL) patients were examined. Coagulation studies were carried out in 13 of them during their active stage and 7 in the latent stage. From these 13 patients, 6 were re-examined when the disease became latent. From these observations a conclusion can be drawn that there are coagulation abnormalities in the majority of ENL patients in the active stage and these abnormalities will return to normal values when the disease becomes latent.