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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal The Indonesian Biomedical Journal Medika Kartika : Jurnal Kedokteran dan Kesehatan Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Jurnal Darma Agung Tunas Medika Jurnal Kedokteran & Kesehatan Jurnal Ilmu Faal Olahraga Indonesia Indonesian Journal of Health Science

Delita Prihatni

Department Of Clinical Pathology, Faculty Of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung

Author-ID : 2505411

Humanities Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Transfusion Reactions in Pediatric Cancer Patients Cakra Jati Pranata; Nur Suryawan; Delita Prihatni
Althea Medical Journal Vol 7, No 4 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v7n4.1820

Background: Transfusion is an essential component of supportive management for cancer patients with anemia and thrombocytopenia. It is generally safe; however, it has several risks and complications including those caused by transfusion reactions. This study aimed to describe transfusion reactions in pediatric cancer patients in a tertiary hospital in Indonesia. Methods: This was a descriptive cross-sectional study with a total sampling method. A prospective analysis was performed on episodes of blood transfusion in pediatric patients aged younger than 18 years old with cancer and were hospitalized at the Department of Child Health of the hospital from July to August 2019. After the consent of the parents, the patients were interviewed for various transfusion reactions. Data collected were presented using tables and charts.Results: Leukemia was the most frequent cancer in children cancer patients who need transfusion. Out of 42 children included, 155 episodes of transfusion were observed with 22 episodes showed transfusion reactions (14.2%). The most frequent manifestations were pruritus (31.8%), followed by combination of pruritus and erythema (27.4%) and fever (13.6%). These reactions appeared mostly in 1 to 2 hours (27.2%), with most were mild reactions (59.1%).Conclusion: Transfusion reactions mostly occurred among pediatric patients with cancer in the acute phase with clinical manifestation of allergic reactions, predominantly mild. Early identification of these reactions would result in better treatment and prevention for recurrence of transfusion reactions.

Neutrophil-to-Lymphocyte Ratio and Covid-19 Symptom-based Severity at Admission M. Fuad; Amaylia Oehadian; Delita Prihatni; Marthoenis Marthoenis
Althea Medical Journal Vol 8, No 1 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v8n1.2255

Background: Increased Neutrophil-to-Lymphocyte Ratio (NLR) is an independent risk factor for mortality in Covid-19 patients and is considered as an early warning sign of Covid-19 severity. This study aimed to observe the differences in NLR at admission between patients with mild, moderate, and severe symptoms of Covid-19 treated in a referral hospital in Banda Aceh, Indonesia.Methods: A total of 114 patients with Covid-19 admitted to a referral hospital in Banda Aceh, Indonesia, during March–September 2020 were included in this study. Demographic information and baseline laboratory data, including the NLR, were collected. Descriptive and inferential statistics were used to analyze the data. Results: The median NLR at admission was higher among patients with moderate to severe symptoms than those with mild symptoms [6.54 (2.80–97.00, IQR 4.81–9.44) vs 2.27 (0.79–5.07, IQR 1.43-2.98), p <0.001]. Covid-19 patients who died had a higher NLR than those who survived [10.88 (4.17–47.50, IQR 7.00–15.17) vs 6.15 (2.80–97.00, IQR 4.63–8.50), p 0.02]. Patients with moderate-severe symptoms had an initial NLR of 4.63–8.50 and decreased to 2.75–5.43 at the end of the treatment had a greater chance of survival. There was an increased probability of death in patients with moderate-severe symptoms whose initial NLR was 7.00–15.17, which was then elevated to 14.33–23.25.Conclusion: Different NLR at admission is seen among Covid-19 patients with mild and moderate-severe symptoms, leading to significantly different outcomes. The NLR can be used as a simple parameter to determine the severity of the disease and predict the outcome of Covid-19 patients.

Therapeutic Outcomes of Pediatric Acute Myeloblastic Leukemia Patients at a Tertiary Hospital in Bandung, Indonesia Filbert Lois Marcus; Nur Suryawan; Delita Prihatni
Althea Medical Journal Vol 9, No 1 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v9n1.2315

Background: Acute myeloblastic leukemia (AML) is a subtype of leukemia characterized by myeloid infiltration into the bone marrow, blood, and other tissues. AML ranks 5th malignancy in children and the prognosis is poor. After chemotherapy, the outcomes vary. Therefore, this study aimed to provide further insight into the therapeutic outcomes of pediatric AML patients. Methods: This study was conducted with a cross-sectional descriptive method. The data were obtained from the medical records of children diagnosed with AML at the Department of Child Health of Dr. Hasan Sadikin General Hospital in 2017–2019 with the total sampling method. Data including age at determination, gender, laboratory values including hemoglobin, leukocyte, thrombocyte as well as blast cell count on peripheral blood smear were collected. Also, the bone marrow punctures gathered were clustered based on the French-American-British (FAB) classification. Data were presented in tables.Results: In total, 46 data of AML patients were retrieved, with the age category at first diagnosis was >5–12 years (48%) and predominantly males (63%), children with moderate anemia (41%), leukocytosis (35%), severe thrombocytopenia (46%), and blast cell count ≥20% (83%). AML-M2 was the most common subtype (30.4%). The majority of patients (91%) underwent chemotherapy and most (45%) patients died during chemotherapyConclusion: The outcome of AML therapy among children is mostly poor, and particularly die during chemotherapy. Early detection and follow-up of patients to continue therapy are important aspects to reduce the mortality rate of AML.

Clinical and Laboratory Manifestation of Children with Acute Lymphoblastic Leukemia as an Assessment of Severity: A Study in Dr. Hasan Sadikin General Hospital Yohana Kusuma Angkasa; Nur Suryawan; Delita Prihatni
Althea Medical Journal Vol 6, No 2 (2019)
Publisher : Faculty of Medicine Universitas Padjadjaran

Background: Acute lymphoblastic leukemia (ALL) is a disease caused by a mutation of lymphoid progenitor cells in bone marrow, that induces uncontrolled lymphoid cell proliferation. ALL is the most common type of leukemia in children. Various clinical and laboratory manifestation makes the diagnostic process more complicated. This study aimed to observe the clinical and laboratory manifestation of children with ALL in Dr. Hasan Sadikin General Hospital for diagnostic and assessment.Methods: The design of this study was a descriptive cross-sectional with a total sampling method. Data of all children under 18 years old with ALL diagnosed in 2015 to 2017 were included. The diagnosis of ALL was confirmed by examination of hematology indices, peripheral blood smear, and bone marrow aspiration classified by FAB. Inaccessible or incomplete medical records were excluded.Results: In total, 192 data of ALL patients were included. Most ALL patients predominantly occurred in boys (59.9%), and the age group of 1–5 years old (40.6%). The clinical manifestations were pallor (89.6%), hepatomegaly (79.7%) and fever (75%). Most patients experienced severe anemia with hemoglobin level <7g/dL (44.8%), leukocytosis >20.000 cells/mm3 (46.9%), severe thrombocytopenia with platelet count <20.000 cells/mm3 (51%), and blast cells count >50% (45.3%). Based on FAB classification, the majority of the patients were classified as ALL type L2 (65.6%).Conclusions: Clinical and laboratory manifestation of ALL patients can be used as a parameter for diagnostic and assessment of severity. Earlier diagnosis would result in better prognosis and more precise treatment for ALL patients.

PERBANDINGAN KADAR ENZIM KREATININ FOSFOKINASE DAN NYERI OTOT SEBELUM DAN SESUDAH LATIHAN BERENANG SELAMA EMPAT MINGGU PADA PERENANG UNIT KEGIATAN MAHASISWA KLUB RENANG Nur Akmal; Reni Farenia; Delita Prihatni
JURNAL ILMU FAAL OLAHRAGA INDONESIA Vol 3, No 1 (2020)
Publisher : PAIFORI

A research has been done to compare the differences on the enzyme creatine phosphokinase (CPK) level and muscle soreness before and after 4-weeks swim practices on swimmers of College swimming club. Eighteen healthy male swimmers (mean ± SD; age: 19,94 ± 1,86 years; weight: 65,28 ± 6,14 kg; height: 1,72 ± 0,43 m) participated in this study. All subjects performed their 4-weeks swim practices which consist of 2x120 hours per week with 500 meters average daily swim distance and weight training. Blood was collected before and after the practices and CPK were analyzed. Questionnaires concerning muscle soreness were filled put before each blood draw. Results were analyzed using normality test and Wilcoxon signed rank test (p<0.05). There was significant increase in CPK level during 4-weeks swim practices by 59.41% (p=0.044). Whereas for muscle soreness (overall and specifically in arms and thighs), there was no significant differences between before and after the 4-weeks swim practices. As a conclusion, participation in 4-weeks swim practices resulted in significant serum CPK enzyme elevation, but there was lack of significance in muscle soreness differences on swimmers of College swimming club.

Platelet-Derived Microparticle Count in β-Thalassemia Patients with Direct Labeling Monoclonal Antibody CD62P and CD41 Ivan Lumban Toruan; Pandji Irani Fianza; Delita Prihatni
Majalah Kedokteran Bandung Vol 52, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Thromboembolic events are potentially life-threatening clinical complications found in β-thalassemia patients. The pathogenesis of the hypercoagulable state in β-thalassemia patients results from the degradation of excess α-globin chains in red blood cells, leading to intracellular labile iron accumulation, oxidative stress, and more rigid, deformed, and eventually prematurely damaged red blood cells. This process is associated with the loss of the normal asymmetrical distribution of membrane phosphatidylserine and its exposure to the outer surface of the blood cell membrane resulting in the formation of tenase complexes, prothrombinase, and thrombin complexes. Increased thrombins lead to platelet activation and platelet-derived microparticles synthesis, which in turn contributes to thrombus formation. This study aimed to determine the increase in the platelet-derived microparticle count by direct labeling of CD62P and CD41 monoclonal antibodies in β-thalassemia patients when compared with normal subjects. This was a cross-sectional analytical quantitative study conducted in Dr. Hasan Sadikin General Hospital Bandung and Dharmais Cancer Hospital Jakarta Indonesia between August and September 2019. Sixty patients, divided evenly into β-thalassemia group and control group, were labeled by CD62P and CD41 monoclonal antibodies. Results showed that the β-thalassemia group had a platelet count of 197x103/uL (58–1,261) with a median count for platelet-derived microparticles of 10,553 events/uL (779–90,971) as opposed to 1,861 events/uL (1,244–3,174) in the normal group (p<0.05). Therefore, the platelet-derived microparticle count in the β-thalassemia patients is 5.7 times greater than in the normal subjects.Jumlah Platelet Derived Microparticles pada Pasien Thalassemia β dengan Metode Pelabelan Langsung Antibodi Monoklonal CD62P dan CD41Kejadian tromboemboli berpotensi komplikasi klinis yang mengancam jiwa ditemukan pada pasien thalassemia β. Patogenesis keadaan hiperkoagulasi pada pasien thalassemia β akibat dari degradasi rantai globin α berlebih dalam sel darah merah yang menghasilkan akumulasi besi labil intraseluler, dan mengarah pada stres oksidatif serta sel darah merah yang lebih kaku dan cacat, dengan akibat kerusakan prematur. Proses ini dikaitkan dengan hilangnya distribusi asimetris normal dari fosfatidilserin membran dan paparannya pada permukaan luar membran sel darah, yang meyebabkan pembentukan kompleks tenase, kompleks protrombinase dan trombin. Peningkatan trombin mengarah pada aktivasi trombosit dan sintesis platelet derived microparticles yang selanjutnya berkontribusi pada pembentukan trombus. Tujuan dari penelitian ini adalah mengetahui peningkatan jumlah platelet derived microparticles dengan metode pelabelan langsung antibodi monoklonal CD62P dan CD41 pada pasien thalassemia β dibanding dengan subjek normal. Penelitian ini merupakan suatu penelitian kuantitatif dengan metode analitik potong lintang yang dilakukan di RSUP Dr. Hasan Sadikin Bandung dan Rumah Sakit Kanker Dharmais Jakarta antara bulan Agustus dan September 2019. Enam puluh pasien, dibagi secara merata menjadi kelompok thalassemia β dan kelompok kontrol, diberi label oleh CD62P dan CD41 antibodi monoklonal. Hasil penelitian menunjukkan kelompok thalassemia β memiliki jumlah trombosit 197x103/uL (58–1.261) dengan jumlah median platelet derived microparticles 10.553 partikel/uL (779–90.971) dibanding dengan 1.861 partikel/uL ( 1,244–3,174) pada kelompok normal (p<0,05). Simpulan, jumlah platelet derived microparticles pada pasien thalassemia β adalah 5,7 kali lebih besar daripada pada subjek normal.

Difference in Immature Reticulocyte Fraction Percentage between Moderate and Severe Anemia in Transfusion-Dependent Thalassemia Rizki Andriyani; Delita Prihatni; Ida Parwati; Tiene Rostini
Majalah Kedokteran Bandung Vol 53, No 4 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n4.2267

Thalassemia is an inherited genetic disease caused by the disruption in globin chain synthesis. Inefective erythropoiesis in thalassemia leads to moderate to severe anemia, requiring routine blood transfusions. To evaluate erythropoiesis, immature reticulocyte fractions (IRF) can be measured using the hematology analyzer, avoiding the need of invasive bone marrow examination. The purpose of this study was to analyze the differences in the IRF percentage between moderate and severe anemia in transfusion-dependent thalassemia (TDT) patients. This was a cross-sectional comparative observational analytic study conducted at the Pediatric Thalassemia Clinic of Dr. Hasan Sadikin General Hospital Bandung in August–September 2020. The IRF was examined using the fluorescence flowcytometry method with whole blood sample added by EDTA anticoagulant. The statistical analysis used in this study was unpaired t-test and Mann Whitney’s test. Subjects were 93 TDT pediatric patients, consisting of 48 boys (52%) and 45 girls (48%). The majority (72%) of the patients had been diagnosed with thalassemia for more than 5 years with moderate anemia (40%) and severe anemia (60%). The median IRF percentage in moderate anemia was 6.4% (range 0-22.7) while the range in severe anemia was 11.7% (range 4.1–35.8), suggesting a statistically significant difference (p<0.001) in the IRF percentage between moderate and severe anemia in transfusion-dependent thalassemia patients. To conclude, the more severe the anemia experienced by a thalassemia patient is, the higher the percentage of IRF.

Correlation Between Serum Ferritin and Testosterone Level in Adolescent Male with Transfusion Dependent Thalassemia Raja Iqbal Mulya Harahap; Nina Tristina; Delita Prihatni; Dewi Kartika Turbawaty
Majalah Kedokteran Bandung Vol 53, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n3.2389

Transfusion-dependent thalassemia (TDT) is a type of beta-thalassemia that needs regular and long-term blood transfusions. Complications can occur due to the deposition of iron in TDT patients, including endocrine complications causing deficiency of testosterone that plays a role in the secondary sexual development in males. The objective of this study was to understand the correlation between ferritin and testosterone level in male adolescences with transfusion-dependent thalassemia. This cross-sectional observational correlative study was conducted from April to August 2019 on 74 males aged 12-18 years old who were presented to the Thalassemia Outpatient clinic, Dr. Hasan Sadikin General Hospital, Bandung. Blood was collected using phlebotomy for ferritin and total testosterone serum examination. Data were then analyzed using SPSS version 17.0. Low testosterone level (<3.0 ng/mL) was found in 63.5% of subjects. Results of the Spearmen correlation test demonstrated a negative correlation with r: -0,699 and p-value <0.001, showing a negative, strong, and significant correlation among those variables. The higher ferritin level in TDT patients indicates a high level of the free iron level in the body that can destroy the endocrine organs and cause deprivation of testosterone secretion, leading to hypogonadism in transfusion dependent thalassemia patients.

Concordance Test of Various Erythrocyte Indices for Screening of Beta Thalassemia Carrier Reni Nurazizah; Renaldi Satria Handika; Edhyana Sahiratmadja; Yoyos Dias Ismiarto; Delita Prihatni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1842

Carrier screening for early detection of thalassemia in the general population needs a careful approach, especially in areas with limited health services. Various erythrocyte indices have been introduced as options for the first stage; however, the low-reliability value of these erythrocyte indices remains the problem. This study aimed to determine the most reliable index for screening beta-thalassemia carriers and distinguish it from iron deficiency anemia. A cross-sectional study was designed to explore thalassemia carrier status among medical students. Inter-rater reliability value of various indices was compared to Shine and Lal index. The Cohen's Kappa coefficient was calculated using SPSS v. 25.0. Among 320 respondents, 295 subjects were non-anemic and 25 were anemic subjects, whereas 105 subjects had low MCV and/or MCH values. Cohen's Kappa value showed moderate reliability results compared to Shine and Lal index for example Mentzer index (0.58), Ehsani index (0.57), Srivastava index (0.53), and Bordbar index (0.41), but showed very low-reliability results with Green and King index (0.04). New cut-off indices based on Kumar et al. were also compared, resulting in moderate reliability results. Since there was no Hb-electrophoresis test, the sensitivities and specificities of those indices could not be calculated. For this reason, a complete blood count can only be used for the early stages of screening for beta-thalassemia carriers, whereas Hb-electrophoresis and DNA tests were considered necessary to perform to confirm a diagnosis.

Correlation between Percentage of Reticulated Platelets and Heart Score in Patients with Suspected Non-ST Elevation Acute Coronary Syndromes Fransisca Mulyadi; Delita Prihatni; Coriejati Rita; Dewi Kartika Turbawaty; Astri Astuti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1633

Thrombus formation in non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) causes increased plateletconsumption, leading to a 20-fold increase of Reticulated Platelets (RP) release. Reticulated platelets have more granulesand proteins that make them quickly forming thrombus than mature platelets, potent to form bigger thrombus, andincrease the risk of Major Adverse Cardiac Events (MACE). HEART score is a risk stratification for possible NSTE-ACS, whichcan predict MACE. The study aimed to analyze the correlation between the percentage of reticulated platelets and HEARTscore. This research was a correlation observational cross-sectional study performed in Dr. Hasan Sadikin Hospital,Bandung, from August 2018 to May 2019. The subjects were patients suspected with NSTE-ACS by clinicians in theEmergency Department of Dr. Hasan Sadikin Hospital. These subjects were assessed for the HEART score andRP percentage. This study involved 52 subjects consisting of a higher number of males (76.9%) aged 45-64 years old (69.2%).HEART score stratification in this study was mostly high risk (69.2%), but none was low risk. Mean of platelet count, absolute3 3 RP, and RP percentage were 271±73 x103/mm , 9.3±4.3 x 103/mm , and 3.6±1.7%, respectively. The correlation testbetween RP percentage and HEART score with a 95% confidence interval using Spearman's correlation test showed asignificant positive correlation with moderate strength (p < 0.001 and r=0.475). The percentage of RP in this study was in thenormal range. However, there was a significant positive correlation with moderate strength between the percentage of RPand HEART scores in patients with suspected non-ST elevation acute coronary syndrome.

Co-Authors Adhi Kristianto Sugianli Agnes Rengga Indrati Amaylia Oehadian Amelia Rachmiwatie Ani Melani Maskoen Astri Astuti Basti Andriyoko Budi Handono Cakra Jati Pranata Coriejati Rita David Rustandi Dewi Kartika Turbawaty Edhyana Sahiratmadja Edhyana Sahiratmadja Filbert Lois Marcus Fransisca Mulyadi Ida Parwati Idaningroem Sjahid Isti Noviani Ivan Lumban Toruan Lastri Supriatin Lelani Reniarti Leni Lismayanti Lisa Milena Anabela M. Fuad M. Marthoenis Muhammad Alamsyah Aziz Mulyanusa Amrullah Ritonga Nida Suraya Nida Suraya Nina Tristina Noormartany Nur Akmal Nur Suryawan Nur Suryawan Nur Suryawan Nurizzatun Nafsi Pandji Irani Fianza Rahmat Sumantri Raissa Yolanda Raja Iqbal Mulya Harahap Renaldi Satria Handika Reni Farenia Reni Nurazizah Rizki Andriyani Roes, Bellya Affan Rubin Surachno Gondodiputro Rully Marsis Amirullah Roesli Shofia Widya Murti Taureni Hayati Tiene Rostini, Tiene Tonggo Gerdina Panjaitan Yohana Kusuma Angkasa Yoyos Dias Ismiarto

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