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Anemia Hemolitik Disebabkan Infeksi Kongenital Citomegalovirus Indah Afriwanty Simatupang; Ricke Loesnihari; Wan Tysa Muhaira
JURNAL RISET RUMPUN ILMU KEDOKTERAN Vol. 4 No. 2 (2025): Agustus : Jurnal Riset Rumpun Ilmu Kedokteran
Publisher : Pusat riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrike.v4i2.6279

Hemolitic anemia is a condition of anemia caused a shortened lifespan of eritrocytes due to an increase in a rate of eritrocytes destruction higer than eritrocytes production in the bone marrow. Congenital Citomegalovirus Infection (CMV) is one of the most common viral infections that causes congenital infections. CMV is transmitted by contact with an individual who carries CMV infection. Approximatelly 90% of congenitally infected infants develop symptoms at birth. Jaundice, petechiae, and hepatosplenomegaly are the three most common sequences in infants. Congenital CMV infection can be diagnosed by isolating the virus by urine and saliva within first three weeks of life. Case Description A 24-day-old baby comes with jaundice all the body since the age of 14 days. Innitially Indah Afriwanty Simatupang, Ricke Loesnihari. Congenital Citomegalovirus Infection., light carried out at hospital but there was no change, the the patient was referred to Adam Malik Hospital. From the examination it was found thrombocytopenia, metabolic acidosis, increased SGOT and SGPT, increased total bilirubin and direct bilirubin, decreased procalcitonin, positive anti CMV IgG, and positive IgG CMV (Avidity). CONCLUSION Based on the history of physical and laboratory examination, its supports the diagnosis of Congenital Cytomegalovirus Infectios.

Modernizing a Classic Test: Validation and Clinical Utility of Infrared-Barrier and Near-Infrared Photometry for Erythrocyte Sedimentation Rate Determination Ester Maduma Napitupulu; Malayana Rahmita Nasution; Ricke Loesnihari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1394

Background: The erythrocyte sedimentation rate (ESR) is a cornerstone laboratory test for monitoring inflammation. The manual Westergren method, while the established gold standard, is slow and hazardous, prompting a shift towards automation. This study provides a rigorous, head-to-head validation of two mechanistically distinct automated technologies—infrared-barrier photometry (IBP) and near-infrared photometry (NIP)—to assess their analytical performance and operational utility in a tertiary care setting. Methods: A cross-sectional method comparison study was conducted on 59 outpatient samples at Adam Malik General Hospital, Indonesia. Each sample was analyzed for ESR using the manual Westergren method, the Caretium XC-A30 analyzer (IBP), and the Mindray BC-760 hematology analyzer (NIP). Method agreement was assessed using Passing-Bablok regression and Bland-Altman analysis. Clinical concordance was evaluated using categorized results. Results: Both automated methods demonstrated excellent agreement with the Westergren reference. Passing-Bablok regression showed no significant proportional or constant bias for either method. The NIP method exhibited a near-perfect regression equation (y = 1.01x - 0.58), while the IBP method also performed well (y = 0.98x + 1.25). Bland-Altman analysis revealed a clinically insignificant mean bias of +0.44 mm/hr for NIP and -4.47 mm/hr for IBP. Clinical concordance was high, with 96.6% of NIP results and 91.5% of IBP results falling within the same clinical category as the Westergren method. Conclusion: Both automated methods are valid and reliable alternatives to the Westergren method. The NIP technology, in particular, offers a substantial leap in laboratory efficiency by providing results in under two minutes from a standard EDTA sample. Its superior workflow integration and strong analytical performance support its adoption to drastically reduce turnaround times and enhance modern patient care pathways.

Modernizing a Classic Test: Validation and Clinical Utility of Infrared-Barrier and Near-Infrared Photometry for Erythrocyte Sedimentation Rate Determination Ester Maduma Napitupulu; Malayana Rahmita Nasution; Ricke Loesnihari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1394

Background: The erythrocyte sedimentation rate (ESR) is a cornerstone laboratory test for monitoring inflammation. The manual Westergren method, while the established gold standard, is slow and hazardous, prompting a shift towards automation. This study provides a rigorous, head-to-head validation of two mechanistically distinct automated technologies—infrared-barrier photometry (IBP) and near-infrared photometry (NIP)—to assess their analytical performance and operational utility in a tertiary care setting. Methods: A cross-sectional method comparison study was conducted on 59 outpatient samples at Adam Malik General Hospital, Indonesia. Each sample was analyzed for ESR using the manual Westergren method, the Caretium XC-A30 analyzer (IBP), and the Mindray BC-760 hematology analyzer (NIP). Method agreement was assessed using Passing-Bablok regression and Bland-Altman analysis. Clinical concordance was evaluated using categorized results. Results: Both automated methods demonstrated excellent agreement with the Westergren reference. Passing-Bablok regression showed no significant proportional or constant bias for either method. The NIP method exhibited a near-perfect regression equation (y = 1.01x - 0.58), while the IBP method also performed well (y = 0.98x + 1.25). Bland-Altman analysis revealed a clinically insignificant mean bias of +0.44 mm/hr for NIP and -4.47 mm/hr for IBP. Clinical concordance was high, with 96.6% of NIP results and 91.5% of IBP results falling within the same clinical category as the Westergren method. Conclusion: Both automated methods are valid and reliable alternatives to the Westergren method. The NIP technology, in particular, offers a substantial leap in laboratory efficiency by providing results in under two minutes from a standard EDTA sample. Its superior workflow integration and strong analytical performance support its adoption to drastically reduce turnaround times and enhance modern patient care pathways.

The Prognostic Utility of Immature Platelet Fraction (IPF) in Adult Sepsis: A Correlation Analysis with SOFA Score and Conventional Platelet Indices Nico Dana Saputra; Ricke Loesnihari; Tasrif Hamdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1419

Background: Sepsis is a leading cause of mortality, driving the search for biomarkers that can accurately reflect its severity. The immature platelet fraction (IPF) measures real-time thrombopoiesis, which is profoundly stressed during sepsis. Its clinical utility relative to conventional platelet indices (MPV, PDW) in predicting organ dysfunction remains to be fully elucidated. This study aimed to explore the relationship between these platelet parameters and the Sequential Organ Failure Assessment (SOFA) score in adult sepsis patients. Methods: An observational, cross-sectional study was conducted on 32 adult patients diagnosed with sepsis at a tertiary hospital in Medan, Indonesia. Upon admission, platelet indices and IPF were measured using a Sysmex XN-1000 hematology analyzer. The SOFA score was calculated to quantify organ dysfunction. The relationships between variables were assessed using Pearson or Spearman correlation analysis. Results: The analysis revealed a statistically significant but weak positive correlation between IPF and the SOFA score (r=0.354, p=0.047). In contrast, conventional indices like MPV (r=0.219, p=0.228) and PDW (r=0.190, p=0.297) showed no significant association with the SOFA score. Mechanistically, strong positive correlations were confirmed between IPF and both MPV (r=0.768, p<0.001) and PDW (r=0.775, p<0.001), reflecting a coordinated bone marrow response. Conclusion: This study reveals a critical paradox in sepsis: while the bone marrow mounts a robust thrombopoietic response, evidenced by the tight correlation between markers of platelet production, this response is poorly coupled with clinical outcomes. The weak association between IPF and organ dysfunction severity suggests that IPF's primary utility may not be as a standalone prognostic tool, but rather as a biomarker of a high-turnover, "futile thrombopoiesis." This highlights the complexity of platelet kinetics in sepsis and warrants further investigation into its role within a multi-marker prognostic strategy.

The Prognostic Utility of Immature Platelet Fraction (IPF) in Adult Sepsis: A Correlation Analysis with SOFA Score and Conventional Platelet Indices Nico Dana Saputra; Ricke Loesnihari; Tasrif Hamdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1419

Background: Sepsis is a leading cause of mortality, driving the search for biomarkers that can accurately reflect its severity. The immature platelet fraction (IPF) measures real-time thrombopoiesis, which is profoundly stressed during sepsis. Its clinical utility relative to conventional platelet indices (MPV, PDW) in predicting organ dysfunction remains to be fully elucidated. This study aimed to explore the relationship between these platelet parameters and the Sequential Organ Failure Assessment (SOFA) score in adult sepsis patients. Methods: An observational, cross-sectional study was conducted on 32 adult patients diagnosed with sepsis at a tertiary hospital in Medan, Indonesia. Upon admission, platelet indices and IPF were measured using a Sysmex XN-1000 hematology analyzer. The SOFA score was calculated to quantify organ dysfunction. The relationships between variables were assessed using Pearson or Spearman correlation analysis. Results: The analysis revealed a statistically significant but weak positive correlation between IPF and the SOFA score (r=0.354, p=0.047). In contrast, conventional indices like MPV (r=0.219, p=0.228) and PDW (r=0.190, p=0.297) showed no significant association with the SOFA score. Mechanistically, strong positive correlations were confirmed between IPF and both MPV (r=0.768, p<0.001) and PDW (r=0.775, p<0.001), reflecting a coordinated bone marrow response. Conclusion: This study reveals a critical paradox in sepsis: while the bone marrow mounts a robust thrombopoietic response, evidenced by the tight correlation between markers of platelet production, this response is poorly coupled with clinical outcomes. The weak association between IPF and organ dysfunction severity suggests that IPF's primary utility may not be as a standalone prognostic tool, but rather as a biomarker of a high-turnover, "futile thrombopoiesis." This highlights the complexity of platelet kinetics in sepsis and warrants further investigation into its role within a multi-marker prognostic strategy.

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