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All Journal Open Access Indonesian Journal of Medical Reviews The International Journal of Medical Science and Health Research
Adang Muhammad Gugun
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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A Comparative Descriptive Analysis of Routine Hematological Profiles in First-Trimester Incomplete Abortion and Anembryonic Pregnancy Indira Putri Fiana Dewi; Adang Muhammad Gugun
The International Journal of Medical Science and Health Research Vol. 17 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/kqfc7t48

Abstract

Introduction: Early pregnancy loss presents in diverse forms, yet a direct comparison of routine hematological profiles between incomplete abortion and anembryonic pregnancy is not well-documented. This study aimed to provide a descriptive comparison of these profiles to highlight potential differences linked to their distinct pathophysiology. Methods: A retrospective, descriptive study was conducted on 60 first-trimester patients: 30 with incomplete abortion and 30 with anembryonic pregnancy. The analysis focused on leukocyte count, platelet count, bleeding time (BT), and clotting time (CT), using descriptive statistics to compare the two cohorts. Results: The incomplete abortion group showed a higher mean leukocyte count (10,883 /µL) and a wider range (6,400–20,100 /µL) compared to the anembryonic pregnancy group (10,110 /µL; range 4,800–17,900 /µL). Mean platelet counts were also slightly higher in the incomplete abortion group. BT and CT were normal and nearly identical between groups. Discussion: The pronounced leukocytosis in the incomplete abortion group is consistent with the greater inflammatory and hemorrhagic nature of this condition. In contrast, the more quiescent hematological profile of anembryonic pregnancy reflects its state as a silent, or "missed," embryonic demise. Conclusion: Routine hematological parameters, particularly leukocyte count, differ between incomplete abortion and anembryonic pregnancy, mirroring the distinct underlying pathophysiology of each condition.
The Paradox of Negative Antibody Screening and Positive Crossmatching: Implications for Transfusion Safety in a Developing Country Suryanto; Adang Muhammad Gugun
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 6 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i6.811

Abstract

Modern antibody screening is a pillar of transfusion safety, intended to prevent hemolytic reactions. However, its ultimate effectiveness, particularly in diverse populations within developing nations where abbreviated crossmatch protocols are not feasible, remains a critical question. This study investigates the "safety gap" between negative screening results and final patient-donor compatibility, aiming to quantify the incidence of serological incompatibility detected by mandatory crossmatching in a tertiary hospital in Indonesia. A descriptive, cross-sectional study was conducted from March to June 2024 at the Blood Bank of PKU Muhammadiyah Yogyakarta Hospital. A total of 299 donor-recipient pairs were analyzed via total sampling. Donor units were screened for irregular antibodies using an automated Column Agglutination Technology (Gel Test) with comprehensive three-cell panels. Subsequently, major and minor crossmatches for all pairs were performed using a Gel Test-based Indirect Antiglobulin Test (IAT) incubated for 15 minutes at 37°C. All 299 donor samples (100%) yielded negative results for irregular antibodies during screening. However, the final crossmatch revealed serological incompatibilities. Major crossmatching (patient serum vs. donor cells) identified incompatibility in 4 cases (1.34%). Minor crossmatching (donor serum vs. patient cells) showed a significantly higher rate of incompatibility, found in 21 cases (7.03%). The predominant blood component transfused was Packed Red Cells (91.97%). In conclusion, the findings demonstrate a significant paradox where a substantial rate of serological incompatibility is only detected by the final crossmatch. This study quantitatively confirms that antibody screening alone is insufficient to guarantee blood compatibility. These results challenge the safety of adopting abbreviated crossmatch protocols in this setting and affirm that the physical crossmatch remains an indispensable, non-negotiable safeguard. This provides critical, region-specific evidence for strengthening hemovigilance systems and reinforcing transfusion policies in Indonesia and other resource-limited nations.
Neurohormonal Synchronization in the Face of Exhaustion: Unveiling the Cortisol-Oxytocin Crosstalk in Type 2 Diabetes Patients with Severe Distress and HPA Axis Blunting Adang Muhammad Gugun; Yusuf Alam Romadhon; Suryanto; Alyssa Sindy Jatiningtyas; Sania Nurul Qurrata
Open Access Indonesian Journal of Medical Reviews Vol. 6 No. 1 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v6i1.824

Abstract

Type 2 diabetes mellitus (T2DM) is increasingly conceptualized as a complex psychoneuroendocrine disorder. While acute physiological stress typically induces hypercortisolemia, chronic diabetes distress may lead to allostatic overload and Hypothalamic-Pituitary-Adrenal (HPA) axis blunting. The compensatory role of oxytocin, a stress-buffering neuropeptide, remains underexplored in this specific clinical phenotype. This study aimed to characterize the neuroendocrine phenotype of patients with uncontrolled T2DM and severe distress, specifically investigating the synchronization between serum cortisol and oxytocin as a marker of homeostatic regulation. In this analytic cross-sectional study, 86 patients with uncontrolled T2DM (HbA1c greater than or equal to 7.0%) and severe diabetes distress (Diabetes Distress Scale-17 mean score greater than or equal to 3.0) were recruited via purposive sampling. Strict exclusion criteria were applied for exogenous steroid use and renal failure to ensure biological validity. Fasting morning serum cortisol and oxytocin were analyzed using Enzyme-Linked Immunosorbent Assays (ELISA). Statistical analysis utilized Spearman’s rank correlation and multivariate linear regression, controlling for Body Mass Index and age. The cohort exhibited severe metabolic dysregulation (Mean HbA1c: 10.03 ± 2.10%) and psychological distress (Mean DDS: 4.65 ± 0.35). Paradoxically, mean morning cortisol was low-normal (170.32 ± 135.43 nmol/L), suggestive of HPA axis blunting rather than the expected hypercortisolemia. A robust positive correlation was observed between cortisol and oxytocin (r = 0.555, p < 0.001). Multivariate regression confirmed cortisol as a significant independent predictor of oxytocin levels (b = 0.521, p < 0.001), independent of metabolic confounders. In conclusion, patients with severe diabetes distress display a distinct phenotype of HPA axis exhaustion coupled with synchronized oxytocinergic activity. This suggests a preserved reactive mobilization mechanism where oxytocin is upregulated in tandem with adrenal output to buffer chronic allostatic load. These findings highlight the potential of the oxytocinergic system as a therapeutic target in diabetes burnout.
Co-Authors Alyssa Sindy Jatiningtyas Indira Putri Fiana Dewi Sania Nurul Qurrata Suryanto Yusuf Alam Romadhon