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Analisis Faktor Risiko Kejadian Malaria Di Kabupaten Batu Bara Tahun 2022, Fitri Wahyuni, Tri Yunis Miko Wahyono

Jurnal Epidemiologi Kesehatan Indonesia

Malaria adalah masalah kesehatan yang serius dan dapat berakibat fatal, terutama pada kelompok risiko tinggi seperti bayi, anak kecil, dan ibu hamil. Selain itu, malaria juga menyebabkan anemia dan menurunkan produktivitas tenaga kerja. Pada tahun 2010, sekitar 65% kabupaten di Indonesia merupakan daerah endemis malaria, dan sekitar 45% penduduk di daerah endemis berisiko tertular malaria. Di Kabupaten Batu Bara, kasus malaria meningkat dari tahun ke tahun. Penelitian ini bertujuan untuk mengetahui faktor-faktor risiko kejadian malaria. Penelitian ini menggunakan kasus-kontrol dan dilakukan pada Juni 2022 di Kabupaten Batu Bara dengan melibatkan responden berusia 12 tahun ke atas sebanyak 170 sampel. Indiividu …

Pengaruh Promosi Kesehatan Melalui Media Sosial Whatsapp Terhadap Pemahaman Ibu Tentang Menu Mpasi Bergizi Di Kabupaten Sumedang, Dini Afriani, Witri Dewi Mentari, Ziana Azahra

Jurnal Epidemiologi Kesehatan Indonesia

Masyarakat menggunakan media sosial sebagai platform untuk berbagi teks, gambar, suara, dan video satu sama lain dan juga dengan pelaku bisnis. Studi ini meneliti pengetahuan ibu tentang menu makanan tambahan yang khas dan kaya nutrisi dengan menggunakan media sosial Whatsapp dan teknik video/teks dalam kelompok. Tujuannya adalah untuk mengetahui dampak dari promosi kesehatan melalui media sosial Whatsapp terhadap pemahaman para ibu mengenai menu makanan tambahan yang khas dan kaya gizi untuk bayi baru lahir. Penelitian ini menggunakan desain One Group Pre-test Post-test untuk pengujian sebelum dan sesudahnya. Dalam penelitian ini, ibu dari anak-anak berusia 6 hingga 24 bulan digunakan. Ibu …

A Comprehensive Scoping Review Of Snoezelen Room In Occupational Therapy Best Practices, Muhammad Hidayat Sahid, Andriani Pratiwi, Mohamad Ghazali Masuri, Akehsan Dahlan

Jurnal Epidemiologi Kesehatan Indonesia

Penelitian ini merupakan analisis komprehensif terhadap literatur, penelitian, dan sumber daya yang terkait dengan ruang Snoezelen, dengan tujuan menyajikan gambaran mengenai manfaat, praktik terbaik, dan potensi aplikasi dari lingkungan multi-sensorik ini. Tinjauan ini mensintesis dan menganalisis secara kritis informasi yang tersedia untuk berkontribusi pada pemahaman dan implementasi ruang Snoezelen bagi individu dengan kebutuhan beragam. Pencarian sistematis basis data elektronik, termasuk PubMed, PsycINFO, dan CINAHL, bersama dengan pencarian manual pada daftar referensi, mengidentifikasi 27 artikel relevan yang memenuhi kriteria inklusi. Proses seleksi yang ketat memastikan inklusi sumber yang berkualitas tinggi dan relevan. Metode ekstraksi dan sintesis data digunakan untuk mengidentifikasi tema …

Hubungan Campak Dengan Berat Badan Kurang Pada Anak Usia 24-59 Bulan Di Indonesia (Analisis Data Survei Status Gizi Indonesia 2021), Wiandhari Esa Gautami, Mondastri Korib Sudaryo

Jurnal Epidemiologi Kesehatan Indonesia

Berat badan kurang atau underweight merupakan masalah gizi kurang yang diukur dengan perbandingan berat badan dan umur. Berat badan kurang pada balita akan mempengaruhi pertumbuhan fisik, kemampuan kognitif, meningkatkan risiko kematian dan penularan infeksi penyakit, salah satu penyakit infeksi yang umum terjadi pada balita adalah campak. Tujuan penelitian ini adalah mengetahui hubungan infeksi campak dengan berat badan kurang pada balita usia 24-59 bulan di Indonesia, dengan mengontrol variabel kovariat diantaranya jenis kelamin, usia, pendidikan ibu BBLR, riwayat TB paru, riwayat diare, riwayat ISPA, riwayat imunisasi campak dan pola makan. Studi ini menggunakan data Survei Status Gizi Indonesia (SSGI) di 34 …

Hubungan Riwayat Komplikasi Kehamilan Dengan Kejadian Perdarahan Pasca Salin Di Indonesia (Analisis Data Survei Demografi Dan Kesehatan Indonesia 2017), Dewiyana Dewiyana, Trisari Anggondowati

Jurnal Epidemiologi Kesehatan Indonesia

Perdarahan Pasca Salin (PPS) merupakan salah satu penyebab utama kematian ibu secara global dan di Indonesia. Berdasarkan Survei Demografi dan Kesehatan Indonesia (SDKI) 2017, masalah kesehatan terbesar yang dikhawatirkan oleh para ibu yang dapat membahayakan seorang wanita ketika melahirkan adalah ibu mengalami PPS (28%). Memprediksi risiko PPS adalah bagian penting dari skrining prenatal dan penilaian pada kehamilan dan persalinan sangat bergantung pada akurasi riwayat kehamilan. Studi cross-sectional ini bertujuan mengetahui hubungan antara riwayat komplikasi kehamilan dengan perdarahan pasca salin di Indonesia menggunakan SDKI 2017. Responden adalah Wanita Usia Subur (WUS) 15-49 tahun yang melahirkan anak terakhir secara per vaginam sebelum …

Pengaruh Komplikasi Kehamilan Terhadap Kematian Neonatal Dini Di Indonesia: Analisis Data Survei Demografi Dan Kesehatan Indonesia (Sdki) 2017, Fatimah Fatimah, Asri Adisasmita Prof

Jurnal Epidemiologi Kesehatan Indonesia

Kematian neonatal dini merupakan penyumbang 2/3 dari kematian neonatal yang merupakan indikator derajat kesejahteraan dan kesehatan bangsa. Tingkat kematian bayi di Indonesia masih cukup tinggi jika dibandingkan dengan negaranegara Asia lainnya. Komplikasi selama kehamilan diduga sebagai salah satu faktor utama penyebab kematian neonatal dini. Tujuan dari penelitian ini adalah untuk menentukan sejauh mana hubungan antara komplikasi kehamilan dan kematian neonatal dini di Indonesia. Penelitian ini mengadopsi pendekatan crosssectional menggunakan set data yang digunakan berasal dari Survei Demografi Kesehatan Indonesia 2017. Variabel dependen pada studi ini adalah kematian neonatal dini dari anak terakhir yang dilahirkan responden yang berusia 15 – 49 …

Desvenlafaxine Induced Acute Angle-Closure Glaucoma - Case Report, Venkatesh Babu Dr, Priyankha Kothandaraman Dr, Megha Sadashiv Dr., Kishor M

Digital Journal of Clinical Medicine

The World Health Organization (WHO) estimates that Depressive disorder affects more than 264 million people worldwide. The global prevalence of depression among those who are aged 18 years and older was approximately 4.4%. According to a 2017 study by India's National Institute of Mental Health and Neuroscience s (NIMHANS), 7.5% of the population in the nation suffers from depression affecting one in 20 Indians_[1].

SSRIs ( Selective Serotonin Re uptake Inhibitors) and SNRIs ( serotonin-nor epinephrine re uptake inhibitors) are increasingly the first-line choices of anti-depressant because of their tolerable side-effect profile and low rate of lethality if …

Successful Application Of Craniosacral Therapy In A Case Of Acute Ptosis Following A Covid-19 Infection., Efterpi Rompoti

Journal of Transformative Touch

This case study offers a unique insight on the effectiveness of CranioSacral therapy (CST) in a 49 year old woman experiencing an acute stage of a viral infection (Covid-19) causing a partial left Oculomotor nerve palsy. A CST glial/Cerebrospinal Fluid (CSF) specific protocol was utilised over 2 consecutive days. The patient recovered fully after 5 days. The results of this particular case can open up the possibility of utilising CST more widely in treating cranial nerve palsies following a viral infection to support the healing process and the functional restoration.

Stopping The Bleed At Uri, Emily Lefebre

Senior Honors Projects

The number one cause of preventable death is uncontrolled bleeding from traumatic injury. From the unlikely scenario of a school shooting, to a campus car accident or an injury during a sports or club event, possessing skills to effectively stop a life-threatening bleed becomes a matter of life or death. The American College of Surgeons Committee on Trauma (ACS COT) STOP THE BLEED® program is a campaign to teach communities how to respond effectively and efficiently to life-threatening bleeding in emergencies. STOP THE BLEED® aims to empower individuals with the knowledge and skills to stop severe bleeding by tourniquet application, …

Eye Infection Risks From Pseudomonas Aeruginosa Via Hand Soap And Eye Drops, Anna Gitter, Kristina D Mena, Karla S Mendez, Fuqing Wu, Charles P Gerba

Faculty, Staff and Student Publications

Eye infections from bacterial contamination of bulk-refillable liquid soap dispensers and artificial tear eye drops continue to occur, resulting in adverse health outcomes that include impaired vision or eye enucleation. Pseudomonas aeruginosa (P. aeruginosa), a common cause of eye infections, can grow in eye drop containers and refillable soap dispensers to high numbers. To assess the risk of eye infection, a quantitative microbial risk assessment for P. aeruginosa was conducted to predict the probability of an eye infection for two potential exposure scenarios: (i) individuals using bacteria-contaminated eye drops and (ii) contact lens wearers washing their hands with …

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

An Internal Audit On Patient Safety And Quality Of Services In A Rural Health Training Center, Coimbatore., Josphine Priscilla Charles, Kathiravan Rajendran, Jenit Osborn

Digital Journal of Clinical Medicine

Prioritizing patient safety is imperative for enhancing quality healthcare, especially in lower- and middle-income countries. Recognizing this urgency, India's Ministry of Health and Family Welfare introduced the 'SaQushal' toolkit, empowering health facilities to self-assess and improve their safety practices. This study presents an internal audit at a Rural Health Training Centre (RHTC) in Coimbatore, India, utilizing the 'SaQushal' framework. The facility achieved an overall score of 63%, exceeding the 50% minimum threshold for each domain, indicating commendable efforts towards establishing good quality standards. Notably, all domains scored above 50%, highlighting strengths across various safety dimensions. While acknowledging this progress, the …

Development Of Solitary Keratoacanthoma From A Cutaneous Wart, Joshua M. Ninan, Veronica Salazar

Research Symposium

Background: Common cutaneous warts, referred to in medicine as verrucae vulgaris, are proliferative lesions caused by human papillomavirus. These lesions are mostly benign and usually resolve without incident, except in the case of the patient mentioned in this report. Our patient developed a solitary keratoacanthoma, currently accepted as a clinical variant of squamous cell carcinoma, as a result of several risk factors and traumatic exposure. The current literature does not have an established association of HPV with solitary keratoacanthomas. This case report explores the presentation and pathogenesis of solitary keratoacanthomas within the setting of HPV.

Case Presentation: 48-year-old Caucasian female …

Learning From The Implementation Of A Surgical Opioid Reduction Initiative In An Integrated Health System: A Qualitative Study Among Providers And Patients, Willemijn L A Schäfer, Julie K Johnson, Meagan S Ager, Cassandra B Iroz, Reiping Huang, Salva N Balbale, Jonah J Stulberg

Faculty, Staff and Student Publications

BACKGROUND: Surgical opioid overprescribing can result in long-term use or misuse. Between July 2018 and March 2019, the multicomponent intervention, Minimizing Opioid Prescribing in Surgery (MOPiS) was implemented in the general surgery clinics of five hospitals and successfully reduced opioid prescribing. To date, various studies have shown a positive outcome of similar reduction initiatives. However, in addition to evaluating the impact on clinical outcomes, it is important to understand the implementation process of an intervention to extend sustainability of interventions and allow for dissemination of the intervention into other contexts. This study aims to evaluate the contextual factors impacting intervention …

A Pharmacist’S Central Role In Improving Hormonal Contraceptive Access, Aleese Smith, Urvi Patel, Alexandra Arledge, Josie Young, Erin Johanson

Annual Research Symposium

In 2019, the roles of Utah pharmacists grew with the implementation of a statewide standing order allowing prescribing abilities for hormonal contraceptives. With the rates of unplanned pregnancies in Utah up to 1 in every 5; pharmacists have a new role in birth control distribution. Pharmacists and pharmacy interns across the state of Utah are able to prescribe self-administered hormonal contraceptive medications including: oral pills, vaginal insertion medications, and birth control patches. Pharmacists are entrusted with the responsibility to evaluate the patient and their needs to ensure all women receiving birth control are educated about the risks and side effects …

Pharmacist Interventions Increase Uptake Of Pneumonia Vaccination In At-Risk Populations: A Review., Kaitlyn Hinton

Annual Research Symposium

Pneumonia is a large burden to healthcare costs and a large cause of hospitalization (Hayes, BH. Chest. 2018, 153(2), 427), and bacterial pneumonia can be prevented through vaccination. While pediatric vaccinations are routinely given, an additional dose is required for adults 65+ years of age or otherwise immune compromised, including diabetics. Only 22.2% of Immunocompromised patients and 65% of the elderly population have received the extra dose (Hung, MC. CDC. 2022). With pharmacist interventions, these vaccination rates could increase significantly. The purpose of this study was to conduct a review of the literature to identify interventions that have yielded higher …

Exploring The Link Between Urinary Albumin Excretion And Neutrophil-To-Lymphocyte Ratio In Type 2 Diabetes Mellitus: A Cross-Sectional Study, B Dharani, S Sugantha Priya, Suba A

Digital Journal of Clinical Medicine

Objectives: Type 2 diabetes mellitus (T2DM) is a chronic disease characterized by persistent hyperglycemia resulting from insulin resistance and inadequate insulin production. A critical aspect of T2DM is its microvascular complications, notably diabetic nephropathy, which progresses from microalbuminuria to overt proteinuria, and eventually End-Stage Renal Disease (ESRD). Inflammation-induced endothelial dysfunction is a key factor in the progression of diabetic nephropathy. The neutrophil-to-lymphocyte ratio (NLR) is an easily measurable marker derived from routine leukocyte analysis, reflecting systemic inflammation. Despite the known association between chronic inflammation and diabetic nephropathy, studies exploring this relationship remain limited. This study aims to investigate the correlation …

Evaluation Of The Role Of Prolactin To Prevent Diabetic Retinopathy, Suliman A. Suliman

Digital Journal of Clinical Medicine

Abstract:

Introduction: Diabetic retinopathy (DR) is a one of the long-term complications of DM and constitutes the leading cause of blindness in working-age individuals and affects a majority of diabetic patients by 20 years after disease onset.

Objective: The aim of this study it investigation of the potential role of prolactin in the prevention of Diabetic retinopathy.

Methods: The study was conducted on 90 diabetic patients who were divided into a group that included 37 patients without retinopathy and a group that included 27 patients with non-proliferative retinopathy and 26 patients with proliferative retinopathy who attended the Endocrinology clinic and …

The Crucial Role Of Community Medicine In Improving Public Health, Malik Maaz Ahmad, Imran Ahmed Khan, Neha Priyanka

Digital Journal of Clinical Medicine

Community medicine, also known as Social and Preventive Medicine, is a specialized field of medicine that focuses on promoting and protecting the health and well-being of communities and populations. Unlike other medical specialties that primarily focus on individual patients, community medicine takes a broader approach, addressing the health needs of entire populations. The specialty of community medicine plays a vital role in clinical practice and public health. Its focus on prevention, population health, and evidence-based medicine makes it an essential discipline in improving the health and well-being of communities. Community-based medical education is of vital relevance in the modern change …

Atypical Immune Response: Acquired Hemolytic Anemia In A Non-Hodgkin Lymphoma Patient With Unusual Findings, Mannan Mangal

Digital Journal of Clinical Medicine

Acquired hemolytic anemia, caused by external factors like autoimmune disorders or infections, includes rare cases of Cold Agglutinin Syndrome (CAS), a cold-antibody-mediated condition affecting 1 in 1 million annually. This report highlights a unique case of CAS in a patient with Non-Hodgkin lymphoma and polyclonal gammopathy, contrasting with the typical presentation of warm-reactive autoantibodies and monoclonal antibodies. The patient presented with weakness, breathlessness, and splenomegaly, with laboratory findings showing a hemoglobin level of 5.8 g/dL and elevated ferritin. Imaging revealed mesenteric lymphadenopathy and thickening of the cecum, suggesting possible lymphomatous involvement. Non-Hodgkin lymphoma was confirmed via lymph node biopsy. This …

Group Approach: Inter-Institute Interactive Sessions For Psychiatry Postgraduate Residents On Mastering The Art Of Prioritization In Everyday Learning., Abhay Koul, Murali M R, Kishor M, Narendra Kumar M S

Digital Journal of Clinical Medicine

Collaboration and knowedge-sharing are essential in Psychiatry as complex mental health challenges require innovative solutions. Inter-institute interactive sessions are important platforms, providing psychiatry postgraduate residents with opportunities to connect, exchange ideas, and advance their understanding of the field collectively. Inter-institution sessions help break the geographic barriers between institutions and build bridges that foster collaboration, networking, and professional growth. There is hardly any literature available on these aspects. The Department of Psychiatry, JSS Medical College, Myusru organized an interactive session between psychiatry post-graduates of JSS Medical College and Mysore Medical College. Students were informed about the rules of the group approach …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Senior Theses

Background: Currently, mandated health screenings in California schools are limited to vision, hearing, and scoliosis; this leaves several other body systems unmonitored during the crucial years of childhood development. One such system is the gastrointestinal (GI) system, which plays a vital role in the normal growth, nutrition status, development, and overall health of children. Objective: By developing and implementing a GI-specific screening tool in the outpatient school setting, this research aims to increase the detection of GI disorders in children. Not only that, but school nurses can use this novel screening tool to promote early diagnosis, intervention, and …

Nutrient Profile Assessment Of A Meal Program Impact On Older Adults' Diet Quality And Food Security Status, Millicent Yaa Gyasiwaa Ms

Theses and Dissertations--Nutrition and Food Systems

The rise in food insecurity globally has ignited institutions and organizations to implement policies and programs to reduce the burden on vulnerable people including older adults and people living in underserved areas. Though programs such as congregate, home-delivered meals, and pantries have been initiated to contribute to reducing food insecurity the nutrient content of these meals including recovered meals and their effect on food security status, food quality, and health has not been widely studied. The current study, Meals on Wings (MOW), assessed the nutrient profile of the free meals offered 4 times per week for 3 months, from May …

Role Of Social Determinants Of Health And The Renin- Angiotensin Aldosterone System In Risk For Hypertensive Disorders Of Pregnancy And Related Adverse Outcomes., Esther Letushila Ndashaala

Theses and Dissertations--Nutrition and Food Systems

Background: Hypertensive disorders of pregnancy (HDP) represent a significant public health issue, contributing to maternal and fetal morbidity and mortality. Women from lower socioeconomic backgrounds or marginalized racial and ethnic groups face higher risks of HDP, which have been incompletely described. In addition, risk for HDP may be linked to a reduction in the normal activity of the renin-angiotensin-aldosterone system (RAAS). This study investigates the role of socioeconomic factors and RAAS components in the risk for HDP and adverse maternal and neonatal outcomes. Methods: This study is a secondary analysis of data from 180 pregnant individuals from a high-risk maternal-fetal …

Addressing Healthcare Disparities Faced By Aging Down Syndrome Populations, Rhea Mistry

Pitzer Senior Theses

Down syndrome (DS) is a chromosomal genetic condition that impacts the development of the body and brain. The life expectancy of individuals with DS has drastically improved over the decades, increasing from 9 years in 1929 to 25 years in 1983 and further reaching 60 years by 2002. Individuals with DS face a variety of prominent co-occurring health conditions that are subject to change over time, including cognitive, visual, and hearing impairments, sleep apnea, cardiovascular defects, Down syndrome regression disorder, and dementia. Despite this increase in life span, DS is still most familiar to pediatric care providers, resulting in healthcare …

Understanding Guardian Perceptions Of Whole-Foods Plant-Based Diets As Interventions In Pediatric Medicine, Vijay R. Luthra

Honors Undergraduate Theses

The obesity epidemic is widespread in American society, often affecting children who bear its consequences innocently. Due to a lack of nutrition knowledge, children rely on caregivers to meet their nutritional needs and instill healthy habits. This study examines parents' attitudes, knowledge, and behaviors, as well as perceived barriers to adopting a whole-foods plant-based diet (WFPD) for their children. Using a modified survey instrument by Morton et al., this study focused on parents and children regarding dietary choices. Participants were recruited from the waiting area of a pediatric clinic at the Medical College of Georgia between April and May 2023. …

Grading Of Malnutrition Among Under 5 Children Residing In Urban Slum In Mysuru Using Who Classification And Indian Academy Of Pediatrics (Iap) Classification: A Comparative Study, Ravali Annaram Dr, Amogha Shree Dr, Saurish Hegde Dr, Krishnaveni Y S Dr

Digital Journal of Clinical Medicine

Background

Malnutrition in Indian children under five is widespread, driven by insufficient food intake and diseases like diarrhoea and respiratory infections. Factors such as food security, maternal literacy, and healthcare access influence malnutrition rates. Growth monitoring utilizes WHO standards globally and IAP guidelines in India. Implementing these charts improves early identification and management of malnutrition, crucial for addressing childhood health challenges in India. This study compare the prevalence of malnutrition in WHO classification with Indian Academy of Paediatrics (IAP) classification among under 5 children residing in urban slum.

Methodology

A community based cross-sectional study was conducted among children aged 6 …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …