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All Journal Medical Journal of Indonesia Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Cermin Dunia Kedokteran
Mansyur Arif
Departemen Ilmu Patologi Klinik, Fakultas Kedokteran Universitas Hasanuddin Jl. Perintis Kemerdekaan km.10 Makasar, Sulawesi Selatan 90245, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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Differences between several atherogenic parameters in patients with Controlled and Uncontrolled Type 2 Diabetes Mellitus Susanti, Ellis; Donosepoetro, Marsetio; Patellongi, Ilhamjaya; Arif, Mansyur
Medical Journal of Indonesia Vol 19, No 2 (2010): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (129.407 KB) | DOI: 10.13181/mji.v19i2.392

Abstract

Aim to assess the differences between Atherogenic Index of Plasma (AIP), ratio of oxidized-Low Density Lipoprotein (Ox-LDL)/High Density Lipoprotein (HDL) and ratio of Lipoprotein-associated Phospholipase A2 (Lp-PLA2)/HDL in predicting the risk of coronary heart disease (CHD) in patients with controlled and uncontrolled type 2 Diabetes Mellitus (T2DM).Methods The study was done observationally with cross sectional design. A total of 80 patients, consisted of 40 controlled and 40 uncontrolled T2DM. The serum triglyceride (TG), HDL-C, Ox-LDL, Lp-PLA2 were examined in their relationship with T2DM risk. AIP is a ratio calculated as log (TG/HDL-C).Results AIP and ratio of Ox-LDL/HDL were significantly higher in uncontrolled than controlled T2DM (0.72 + 0.13 vs 0.47 ± 0.22 , p < 0.001) and (1738.8 ± 625.5 vs 1418 ± 535.3, p = 0.02), but no significant difference was found in ratio of Lp-PLA2/HDL (5.09 ± 2.17 vs 5.95 ± 3.11, p = 0.16).Conclusion AIP and ratio of Ox-LDL/HDL value were significantly higher in uncontrolled than in controlled T2DM. These parameters may be beneficial in predicting the risk of atherosclerosis in diabetic patients. (Med J Indones 2010; 19:103-8)Keywords: AIP, atherosclerosis, Diabetes Mellitus, HDL, Lp-PLA2, Ox-LDL  
Juvenile-type Chronic Myeloid Leukemia pada Bayi Usia 3 Bulan Sanda, Arfandhy; Abdullah, Agus Alim; Arif, Mansyur; Ridha, Nadirah Rasyid
Cermin Dunia Kedokteran Vol 46, No 2 (2019): Penyakit Dalam
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (666.657 KB) | DOI: 10.55175/cdk.v46i2.523

Abstract

Leukemia Mieloid Kronik (LMK) pada anak mencakup 2-5% kasus mieloproliferatif pada anak. LMK pada anak dibagi dalam 2 tipe yaitu tipe dewasa dan tipe remaja berdasarkan ada tidaknya kromosom Philadelphia beserta fusi gen BCR-ABL dalam kromosom tersebut. Kasus Seorang bayi laki-laki usia 3 bulan dengan keluhan utama perut membesar. Diagnosis berdasarkan gejala klinis and pemeriksaan laboratorium : leukosit 41.700/µl, hemoglobin 8,6 g/dl, trombosit 46.000/µl. Pada apusan darah tepi ditemukan semua tahapan maturasi sel seri mieloid dan mieloblast 5%. Aspirasi sumsum tulang mendapatkan peningkatan leukopoietik dengan semua tahapan maturasi mieloid. Malaria mikroskopik negatif. Hasil pemeriksaan molekular tidak ditemukan fusi gen BCR-ABL.Chronic myeloid leukemia (CML ) consist of 2-5% of myeloproliferative cases in children. CML in children are divided into two types: adult and juvenile type based on presence of Philadelphia chromosome with fusion gene BCR-ABL in chromosome. Case A baby boy aged 3 months with chief complaint of enlarged abdomen. Diagnosis was based on clinical symptoms and laboratory tests : leukocytes 41.700/µl, hemoglobin 8.6 gr/dl, platelets 46,000/µl. Peripheral blood smear shows all stages of cell myeloid series maturation and 5% myeloblast. Bone marrow aspiration shows increased leukopoietic activity and all stages of myeloid cell series. Malaria microscopy was negative. Molecular test results found no BCR- ABL fusion gene.
Analisis Kaitan Jumlah Trombosit dengan Mortalitas Pasien Infark Miokard Akut selama Perawatan Kurniawan, Liong Boy; Bahrun, Uleng; Arif, Mansyur; ER, Darmawaty
Cermin Dunia Kedokteran Vol 41, No 9 (2014): Diabetes Mellitus
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (112.615 KB) | DOI: 10.55175/cdk.v41i9.1102

Abstract

Latar belakang Trombosit berperan dalam aterotrombosis dengan menghasilkan enzim yang dapat mendegradasi matriks sehingga plak aterosklerosis mudah ruptur. Ruptur plak akan menyebabkan adhesi, aktivasi dan agregasi trombosit sehingga membentuk trombus yang dapat mematikan sel otot jantung. Jumlah trombosit diduga berkaitan dengan mortalitas pasien infark miokard akut. Tujuan Untuk mengetahui jumlah trombosit pasien infark miokard akut saat masuk rumah sakit dan menilai kaitannya dengan mortalitas pasien selama perawatan di rumah sakit. Metode Penelitian ini merupakan studi retrospektif dengan analisis potong silang, menggunakan data sekunder rekam medik 81 pasien infark miokard akut yang dirawat di Unit Perawatan Jantung Intensif Rumah Sakit dr. Wahidin Sudirohusodo, Makassar periode Juli 2010 hingga Juni 2011. Jumlah trombosit yang diteliti adalah jumlah trombosit saat pasien masuk rumah sakit. Uji statistik dengan Uji T dan Mann Whitney. Hasil Rerata jumlah trombosit penderita infark miokard akut yang survive dan meninggal selama perawatan adalah 245,02+69,58/µL dan 259,18+111,17/µL (p=0,543). Tidak ditemukan hubungan antara tingkat mortalitas dengan jumlah trombosit secara keseluruhan (p=0,433). Pasien dengan trombositosis memiliki risiko mortalitas 4,27 kali dibandingkan dengan jumlah trombosit normal (p=0,256, 95%IK 0,368-49,676) sedangkan pasien dengan trombositopenia memiliki risiko mortalitas 1,71 kali dibandingkan dengan pasien dengan jumlah trombosit normal (p=0,471, 95%IK 0,418-6,993). Simpulan Tidak ditemukan perbedaan bermakna jumlah trombosit pasien yang survive dan yang meninggal selama perawatan, tetapi ditemukan kecenderungan peningkatan mortalitas pada pasien infark miokard akut dengan trombositosis dan trombositopenia dibandingkan dengan pasien dengan jumlah trombosit normal.Background Platelet has important role in atherothrombosis by producing enzymes which may degrade matrix leading to plaque rupture. Rupture of plaques induces platelet adhesion, activation and aggregation forming thrombus which can cause myocardial infarction. Platelet counts are thought to correlate with mortality of acute myocardial infarction patients. Objective To observe platelet counts at admission among acute myocardial patients and to evaluate its influence to in-hospital mortality. Method A retrospective study with cross sectional approach was performed using secondary data from 81 acute myocardial infarction patients hospitalized in Intensive Cardiac Care Unit of dr. Wahidin Sudirohusodo Hospital Makassar from June 2010 to July 2011. Platelet counts at admission were analyzed and statistical analysis was performed using T and Mann Whitney Tests. Results The mean platelet counts at admission in the in-hospital survived and non survived acute myocardial infarction patients were 245.02+69.58/µL and 259.18+111.17/µL respectively (p=0,543). No correlation found between mortality rate and overall platelet count (p=0.433). Patients with thrombocytemia had 4.27 times mortality rate compared to normal platelet counts patients (p=0.256, 95% CI =0.368-49.676) while thrombocytopenia patients had 1.71 times mortality rate compared to those with normal platelet counts (p=0.471, 95% CI =0.418-6.993). Conclusion No significant difference of platelet counts at admission in the in-hospital survived and non survived acute myocardial infarction patients; patients with thrombocytemia and thrombocytopenia had tendency of higher mortality compared to patients with normal platelet counts. 
Pengaruh Jumlah Leukosit terhadap Mortalitas Pasien Infark Miokard Akut selama Perawatan Kurniawan, Liong Boy; Bahrun, Uleng; Arif, Mansyur; ER, Darmawaty
Cermin Dunia Kedokteran Vol 42, No 10 (2015): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (185.963 KB) | DOI: 10.55175/cdk.v42i10.953

Abstract

Latar belakang: Patogenesis infark miokard akut melibatkan proses inflamasi sistemik, intraplak, ataupun miokardium. Neutrofil menginfiltrasi plak koroner dan miokardium yang mengalami infark serta memediasi terjadinya kerusakan jaringan melalui pelepasan enzim pendegradasi matriks dan spesies oksigen reaktif. Leukosit yang berperan dalam patogenesis infark miokard diduga berkaitan dengan mortalitas pasien infark miokard akut. Tujuan: Mengetahui kaitan jumlah leukosit, persentase neutrofil, limfosit, dan rasio neutrofil limfosit terhadap mortalitas pasien selama perawatan di rumah sakit. Metode: Studi retrospektif dengan menggunakan data sekunder dari rekam medik 64 pasien infark miokard akut yang dirawat di Unit Perawatan Jantung Intensif Rumah Sakit Dr. Wahidin Sudirohusodo, Makassar, periode Juli 2010 hingga Juni 2011. Dilakukan analisis pada jumlah leukosit, neutrofil, limfosit, dan rasio neutrofil limfosit yang diperoleh dari data hasil tes laboratorium saat pasien masuk rumah sakit. Uji statistik dilakukan dengan uji T, Mann Whitney, dan chi square. Hasil: Rerata jumlah leukosit, persentase neutrofil, limfosit, dan rasio neutrofil limfosit pada penderita infark miokard akut yang survive dan meninggal selama perawatan berturut-turut adalah 11.920+3.610/µL vs 14.410+3.090/µL (p=0,009), 73,98+11,16 vs 76,04+9,74 (p=0,647), 17,29+9,03 vs 15,00+7,00 (p=0,379), dan 5,97+3,90 vs 6,80+4,72 (p=0,403). Pasien dengan leukositosis memiliki risiko mortalitas 10,71 kali dibandingkan dengan jumlah leukosit normal (p=0,009; 95% interval kepercayaan (IK) 1,307 s/d 87,846). Simpulan: Rerata jumlah leukosit pada pasien infark miokard akut yang meninggal selama perawatan lebih tinggi dibandingkan dengan pasien yang survive. Pasien dengan leukositosis memiliki risiko mortalitas selama perawatan lebih tinggi dibandingkan pasien dengan jumlah leukosit normal.Background: Pathogenesis of acute myocardial infarction involves systemic, intraplaque, and myocardial inflammatory processes. Neutrophils infiltrated coronary plaque and infarcted myocardium, also mediate tissue damage through release of matrix degradation enzymes and reactive oxygen species. Leukocyte is suspected to be related to mortality in acute myocardial infarction patients. Objective: To investigate the relationship of leukocyte count, neutrophils and lymphocyte percentages, also neutrophils and lymphocyte ratio with in-hospital mortality of acute myocardial infarction patients. Method: A retrospective study with using secondary data from medical record of 64 acute myocardial infarction patients hospitalized in Intensive Cardiac Care Unit of Dr. Wahidin Sudirohusodo Hospital, Makassar, from June 2010 to July 2011. Admission leukocyte count, percentages of neutrophils and lymphocyte, and neutrophils lymphocyte ratio were analyzed statistically using T, Mann Whitney, and chi square tests. Results: The mean of leukocyte count at-admission, percentages of neutrophils and lymphocyte, and neutrophil : lymphocyte ratio in survived and non survived acute myocardial infarction patients were 11920+3610/µL vs 14410+3090/µL (p=0.009), 73.98+11.16 vs 76.04+9.74 (p=0.647), 17.29+9.03 vs 15.00+7.00 (p=0.379), and 5.97+3.90 vs 6.80+4.72 (p=0.403) respectively. Patients with leukocytosis had 10.71 times mortality rate compared to patients with normal counts (p=0.009; 95% CI =1.307-87.846). Conclusion: Leukocyte count in non-survivors was significantly higher than in survivors. Patients with leukocytosis had higher mortality risk compared with normal count patients.
Hasil Positif Palsu Tes Morfin pada Skrining Urin Narkoba Diduga Akibat Rifampisin Kurniawan, Liong Boy; Widaningsih, Yuyun; Sennang, Nurhayana; Bahrun, Uleng; Arif, Mansyur
Cermin Dunia Kedokteran Vol 42, No 1 (2015): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (243.256 KB) | DOI: 10.55175/cdk.v42i1.1054

Abstract

Hasil positif palsu pada tes skrining urin narkoba dengan metode imunologi jarang terjadi. Pemastian hasil memerlukan anamnesis yang baik mengenai konsumsi obat dan konfirmasi dengan tes yang lebih spesifik, biasanya dengan metode kromatografi gas/spektrometri massa. Beberapa substansi dilaporkan dapat menyebabkan hasil positif palsu. Dilaporkan satu kasus laki-laki 18 tahun dengan hasil positif morfin (tes urin narkoba) menggunakan metode imunologi kompetitif. Setelah anamnesis ketat diketahui bahwa pasien tersebut dalam pengobatan rifampisin selama 6 bulan karena tuberkulosis dan tidak pernah mengkonsumsi narkoba. Sampel urin berwarna kemerahan (hasil ekskresi metabolit rifampisin melalui urin). Diperlukan konfirmasi pasti dengan metode lebih spesifik dengan kromatografi gas/spektrometri massa (standar baku emas).False positive reports on urine drug screening using immunoassay method are rare. Confirmation should be done through detailed anamneses on consumed drugs that may interfere result and perform test with more specific method such as gas chromatography/mass spectrometry (GC-MS). Some substances have been reported as the causes of false positive test. A case reported to have positive on morphine urine drug test using competitive immunoassay from an 18 year-old male. The patient was on 6-month rifampicin treatment for tuberculosis and had no history of substance abuse. The urine sample was reddish due to rifampicin metabolite excretion. Confirmation with gas chromatography/mass spectrometry method should be performed as gold standard.
Weak Antigen dan Mixed Field Agglutination pada Pasien Diduga Chronic Myeloid Leukemia Syahrir, Wandani; Muhiddin, Rachmawati; Arif, Mansyur
Cermin Dunia Kedokteran Vol 44, No 3 (2017): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (816.318 KB) | DOI: 10.55175/cdk.v44i3.833

Abstract

Seorang wanita, 24 tahun, masuk rumah sakit dengan keluhan utama lemah sejak 1 minggu. Pasien didiagnosis diduga chronic myeloid leukemia (CML) sejak 4 bulan. Pada pemeriksaan fisis ditemukan kesan anemis, splenomegali masif dan hepatomegali. Pemeriksaan laboratorium mendapatkan hemoglobin 6,6 g/dl, eritrosit 1.480.000/mm3, leukosit 629.080/mm3, trombosit 149.000/mm3. Golongan darah A (positif-2 /weak antigen), rhesus negatif dan incompatibility minor mixed field. Pada CML terjadi injury DNA yaitu translokasi pada kromosom 9 dan 22. Translokasi pada kromosom 9 diduga menyebabkan weak/missing antigen pada eritrosit, terkait incompatibility minor mixed field. Pada kasus ini darah dapat ditransfusikan karena incompatible minor mixed field samadengan auto control indirect antihuman globulin test. Perlu informasi diagnosis dan riwayat penyakit sebelumnya pada pemeriksaan pretransfusi.A 24-year-old woman was hospitalized with chief complaint general weakness since the previous week. She had been suspected with Chronic Myeloid Leukemia (CML) since 4 months ago. The patient was anemic, with massive spleen and liver enlargement. Laboratory examination found haemoglobin 6.6 g/dL, RBC 1.480.000/mm3, leukosit 629.098/mm3, trombosit 149.000/mm3. Blood group A (positive-2, weak antigen), rhesus negative, and mixed field minor incompatibility. In CML, there is DNA injury which is translocation of chromosomes 9 and 22. Translocation of chromosome 9 is correlated with weak/missing antigen on the erythrocytes related to mixed field minor incompatibility. In this case, the blood could be transfused because the minor incompatibility was equal with the autocontrol indirect antihuman globulin test. Information of previous medical history is necessary in the pretransfusion examination. 
White Blood Cell and Peripheral Blast Counts in Leukemia Patients with Non-Graying WBC-Diff Scattergram Lismayanti, Leni; Arif, Mansyur
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2222

Abstract

Graying scattergram of White Blood Cell differential (WBC-diff) is often accompanied by blasts in the blood and/or leukocytosis in leukemia patients. Therefore, monitoring White Blood Cell (WBC) and peripheral blast count is crucial for patient management. In contrast, patients with non-graying WBC-diff scattergrams may have varying WBC counts and peripheral blasts. This study aimed to establish the cut-off values of WBC and peripheral blast counts that could predict a non-graying scattergram in leukemia patients. A retrospective descriptive study with a cross-sectional design analyzed secondary data from 21 leukemia patients. The acute and chronic leukemia diagnosis were based on bone marrow aspirates, which simultaneously showed a graying WBC-diff scattergram on Complete Blood Count (CBC). Receiver Operating Characteristic (ROC) curve analysis was conducted when the patient’s CBC displayed a non-graying scattergram. The cut-off value for WBC count was 16,380 x 109/L with an Area Under Curve (AUC) of 0.932, a sensitivity of 85.7%, p = 0.001, and the cut-off for peripheral blast count was 35.5% with an AUC of 0.872, the sensitivity of 76.2%, p=0.001. The results suggest that a non-graying scattergram of the WDF channel in leukemia is more likely associated with WBC counts below 16,380 x 109/L and peripheral blast counts below 35.5%, which have excellent and good predictive value.
Analysis of Immature Platelet Fraction in Patients with Solid Tumors Undergoing Chemotherapy Runtuwene, Aliza Virginia Eunike; Abdullah, Agus Alim; Arif, Mansyur
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2277

Abstract

Thrombocytopenia is a common side effect in patients undergoing chemotherapy. Examination of platelet count parameters alone cannot predict the platelet recovery response. Immature Platelet Fraction (IPF) can be used as an additional parameter to determine the etiology of thrombocytopenia. This study aimed to analyze IPF, and other platelet-related parameters related to the effects of chemotherapy on solid tumor patients. A prospective observational study design involving 35 solid tumor patients undergoing chemotherapy at Dr. Wahidin Sudirohusodo Hospital, Makassar, was carried out from August to September 2023. Platelet-related parameters (PLT, PDW, IPF, AIPF, and MPV) were measured using an automatic hematology analyzer. Kolmogorov-Smirnov, paired T-test, Wilcoxon, and Spearman test were used for statistical analysis. There was a significant difference in mean PLT, IPF, PDW, and MPV (p < 0.05) before and after chemotherapy. There was a positive correlation in differences in IPF, MPV and PDW (p < 0.001) with a strong correlation (r =0.6-0.8). There was a negative difference in IPF and PLT (p=0.068) with moderate correlation (r =0.312). Chemotherapy causes a significant decrease in platelets and a significant increase in IPF. Routine blood tests and IPF are useful for monitoring thrombocytopenia due to the effects of chemotherapy.
Co-Authors Abdullah, Agus Alim Abdullah, Agus Alim Darmawaty ER, Darmawaty Ellis Susanti Ilhamjaya Patellongi Leni Lismayanti Liong Boy Kurniawan, Liong Boy Marsetio Donosepoetro Muhiddin, Rachmawati Nadirah Rasyid Ridha, Nadirah Rasyid Nurhayana Sennang, Nurhayana Runtuwene, Aliza Virginia Eunike Sanda, Arfandhy Syahrir, Wandani Uleng Bahrun, Uleng Widaningsih, Yuyun