Immune Thrombocytopenia Purpura (ITP) is a disease characterized by thrombocytopenia, which is diagnosed by excluding other causes of thrombocytopenia. In recent years, there have been many studies on the association between Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) values with ITP, but the results have not been consistent. This study aims to determine the association between mean MPV and PDW with the severity of ITP. Materials and methods: a cross-sectional study involving 100 ITP patients aged more than 18 years at Dr. Wahidin Sudirohusodo Hospital Makassar, Indonesia. The diagnosis of ITP was established by excluding all causes of thrombocytopenia. MPV and PDW values were obtained from the patient's complete blood test results. Data were analyzed using Statistical Packages for Social Science (SPSS) statistical software version 26. Results:  This study included 100 ITP patients. It was found that MPV was significantly high (p = <0.001) in severe ITP compared to mild and moderate (1.8% vs 17.5% vs 80.7%). PDW was significantly high (p = <0.001) in severe ITP compared to mild and moderate (9.5% vs 15.9% vs 74.6%). MPV value of 13.65 fL was predictive of severe ITP with a sensitivity of 72.40% and specificity of 83.30% and PDW value of 18.8 fL was predictive of severe ITP with a sensitivity of 79.30% and specificity of 76.20%. Conclusions: High values of MPV and PDW were more common in patients with severe ITP. In addition, the mean of MPV and PDW were also found to be higher along with the severity of ITP

Hepatitis B and Metabolic Associated Fatty Liver Disease (MAFLD) are conditions that can contribute to the development of liver fibrosis. Hepatitis B triggers long-term liver inflammation and activates stellate cells, which play a role in the formation of fibrotic tissue. On the other hand, MAFLD is closely associated with metabolic syndrome, including obesity, dyslipidemia, and insulin resistance. When both conditions coexist, the risk of fibrosis progression increases, accelerating the transition to cirrhosis and other hepatic complications. The aim of this study is to determine the effect of hepatitis B and MAFLD on the occurrence of liver fibrosis. Materials and Methods: a descriptive study using a cross-sectional design. The study involved all patients diagnosed with hepatitis B at Wahidin Sudirohusodo General Hospital in Makassar between August 2024 and February 2025. Hepatitis B diagnosed based on serum hepatitis B antigen. The criteria of MAFLD based on the presence of hepatic steatosis accompanied by obesity, type 2 diabetes mellitus, or metabolic syndrome. Patients are categorized into Group 1: patients with hepatitis B and Group 2: patients with hepatitis B and MALFD. Liver fibrosis assessed using transient elastography (FibroScan), categorized into non-advanced fibrosis (F2-F3) and advanced fibrosis (>F4). Results: Among 98 patients with hepatitis B, 43 patients (43.9%) had MAFLD. Group 2 had significantly higher liver stiffness (p<0.05) compared to group 1 (11.19 kPa vs 17.1 kPa). Group 2 had a significantly higher incidence of advanced fibrosis compared to Group 1 (60.6% vs 39.4%) and 2.8-fold more likely to develop advanced liver fibrosis (OR: 2.809; 95% CI 1.184–6.664; p = 0.017). HBeAg-negative was significantly associated with more advanced fibrosis compared to HBeAg-positive (OR: 11.610; 95% CI 3.766–35.791; p < 0.05). Conclusion: Patients with hepatitis B accompanied by MALFD have a higher average liver stiffness compared to patients with hepatitis B alone. HBeAg-negative status is the most significant factor contributing to the occurrence of liver fibrosis.

Background: Increasing  parental  vaccination  hesitancy  is  fueled  by  concerns  of  vaccination  safety  and effectiveness, widespread misinformation, and barriers to vaccines availability and accessibility. Vaccination uptake against rotavirus remains suboptimal in low-middle income countries. We aimed  to  study  the  knowledge,  attitude,  and  practice  (KAP)  of  Lebanese  parents  towards vaccination with a focus on Rotavirus vaccine. Methods: A cross-sectional study was conducted in 2 public and 2 private schools in the greater Beirut area in 2017-2018 school year. A questionnaire assessing KAP of vaccination in general and rotavirus vaccine in specific was shared with Lebanese parents of school children between aged 3 to 18 years. Results: The overall response rate was 76.5% (306 out of 400 questionnaires) out of which 221 respondents answered the rotavirus questions. Only 45.25% respondents reported vaccinating their children against rotavirus. Factors associated with higher vaccine uptake included younger parent’s age, higher level of parent’s education, children’s mothers being employed, and higher household incomes (p-values <0.005). Respondents vaccinating against Rotavirus have a more positive attitude towards vaccines in general and 96% reported their child’s pediatrician to be their primary source of information. Lack of pediatrician’s recommendation was the most common reason (55%) for not vaccinating against rotavirus. Conclusion: Vaccination against rotavirus among Lebanese children remains low but increases with higher parental age, education, and income. Cost and lack of awareness were the most significant barriers for vaccination while pediatricians’ recommendation was the most trusted and influential source on parent’s decision to vaccinate. More efforts are needed to disseminate vaccination information through pediatricians’ recommendations and other means and increase vaccine availability and accessibility.