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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
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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Erythrocyte Indices MCV and/or MCH as First Round Screening Followed by Hb-analysis for β-thalassemia Carrier State Edhyana Sahiratmadja; Ani Melani Maskoen; Lelani Reniarti; Delita Prihatni
The Indonesian Biomedical Journal Vol 14, No 3 (2022)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v14i3.1960

Abstract

BACKGROUND: Being located in the global thalassemia belt area, Indonesia is estimated harboring about 10% thalassemia carriers; however, screening program is still diversely scattered across the country. Numerous erythrocyte indices have been introduced to help identifying thalassemia carriers with contradictory results. Therefore, this study had compared the use of mean corpuscular volume (MCV) and/or mean corpuscular hemoglobin (MCH) values and the most erythrocyte indices used in Indonesia which were Mentzer Index (MI) and Shine & Lal Index (SLI), as a first attempt in a mass screening for β-thalassemia carrier.METHODS: This was a retrospective study, evaluating laboratory data from family members of thalassemia major subjects. The sensitivity and specificity of MI and SLI were calculated. HbA2 >3.5% was used as a golden standard for β-thalassemia carrier and DNA examination was conducted to confirm β-globin mutation.RESULTS: Out of 160, 28.8% of the subjects had low Hb concentration. Interestingly, 79.4% of the subjects had low MCV and/or MCH with or without low Hb concentration. In this study, specificity and sensitivity of MI were 82.2% and 83.8%, whereas of SLI were 96% and 40.5%, respectively. Low MCV and/or MCH had covered IVS1nt5 and Cd26 mutation at β-globin gene; whereas MI and SLI had missed some samples, leading to false negative of thalassemia carrier results, when using MI or SLI only.CONCLUSION: MCV<80 fl and/or MCH<27 pg is the best first round mass screening method for β-thalassemia carrier in a limited facility area. However, Hb electrophoresis should be gradually installed regionally in various places wherever possible, as well as DNA analysis to confirm the mutation for an optimal carrier diagnosis.KEYWORDS: HbA2, HbE, iron deficiency anemia, Mentzer Index, Shine and Lal Index
KORELASI PENINGKATAN KADAR TROPONIN I DENGAN MORTALITAS PADA PASIEN DEWASA TERKONFIRMASI COVID-19 Nida Suraya; Lastri Supriatin; Delita Prihatni; Raja Iqbal Mulya Harahap
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 6 No 1 (2023): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Jantung adalah organ kedua setelah paru-paru yang banyak dipengaruhi oleh Severe Acute Respiratory Syndrome Corona Virus-2 (SARS CoV-2), mengalami cedera akibat virus tersebut ditandai dengan peningkatan kadar troponin. Kadar troponin-I secara signifikan lebih tinggi pada pasien COVID-19 berat, mendapat perawatan intensif, dan meninggal. Penelitian ini bertujuan menganalisis hubungan kenaikan kadar troponin-I dengan mortalitas pasien dewasa terkonfirmasi Corona Virus Disease-19 (COVID-19). Penelitian ini bersifat deskriptif retrospektif dilakukan pada pasien COVID-19 rawat inap di RSUP Dr. Hasan Sadikin Bandung dari Desember 2020 hingga Maret 2021 sesuai kriteria inklusi dan eksklusi. Data kadar troponin-I dan karakteristik pasien diambil dari sistem informasi laboratorium dan rekam medis. Hubungan kenaikan kadar troponin I dengan mortalitas dianalisis dengan uji chi-square. Hasil penelitian menunjukkan bahwa dari 90 pasien usia 20-60 tahun sebanyak 48 orang (53,3%), pasien laki-laki sebanyak 57 orang (63,3%), dan pasien dengan komorbid sebanyak 64 orang (71,1%). Peningkatan kadar troponin-I terjadi pada 80% pasien berhubungan secara signifikan dengan mortalitas (p 0,0001) dengan Odds Ratio (OR) sebesar 6,40. Hal ini berarti pasien dengan kadar troponin I meningkat memiliki kemungkinan untuk meninggal 6,4 kali lebih besar daripada pasien dengan kadar troponin-I normal. Kondisi COVID-19 berat dapat menyebabkan kerusakan pada berbagai organ termasuk otot jantung. Pada penelitian ini, pasien COVID-19 dengan kenaikan kadar troponin-I pada masa perawatan memiliki risiko kematian lebih tinggi daripada pasien dengan kadar troponin-I yang normal. Untuk mengevaluasi apakah troponin-I merupakan faktor penyebab kematian yang kuat pada pasien COVID-19 dewasa diperlukan analisis multivariat. Kata kunci: COVID-19, mortalitas, troponin-I DOI : 10.35990/mk.v6n1.p34-43
Association between Maternal Hemoglobin Level and Incomplete Abortion in A West Java Tertiary Hospital, Indonesia Lisa Milena Anabela; Budi Handono; Delita Prihatni; Muhammad Alamsyah Aziz; Mulyanusa Amrullah Ritonga
International Journal of Integrated Health Sciences Vol 11, No 1 (2023)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v11n1.3284

Abstract

Objective: To evaluate the association between maternal hemoglobin concentrations and incomplete abortion.Methods: An analytic, cross-sectional study with consecutive sampling method was conducted using medical records of 45 pregnant women aged 18 – 35 years old visiting the Obstetrics and Gynecology Department of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from January 1, 2017 to December 31, 2019. Participants were grouped into incomplete abortion and non-abortion groups.Results: Maternal characteristics in the incomplete abortion group showed that the majority of pregnant women in this group were 25.58 years of age, non-anemic (n=37, 82.22%), had no previous spontaneous abortion (n=40, 88.89%), and were nulliparous (n=25, 55.55%) with a mean interpregnancy interval of 4.03 years. The characteristics in both incomplete abortion group and non-abortion group were homogenous in the level of anemia (p-value=0.380), previous spontaneous abortion (p-value=1.00), and interpregnancy intervals (p-value=0.667). The mean hemoglobin concentration for the incomplete abortion group was 11.81 gr/dL (95% CI, 11.30 to 12.26). Heterogenous data was found in age (p-value=<0.001) and parity (p-value=0.002). Parity was a strong confounder, causing the hemoglobin concentration insignificantly associated to incomplete abortion (p-value=0.884).Conclusion: No statistically significant association is found between hemoglobin concentration and incomplete abortion. Most women with incomplete abortion are around 25 years old, nulliparous, non-anemic with a mean hemoglobin concentration of 11.81 gr/dL with no history of previous abortion, and a rather secure interpregnancy intervals.
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

Abstract

Thrombus formation in non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) causes increased platelet consumption, leading to a 20-fold increase of Reticulated Platelets (RP) release. Reticulated platelets have more granules and proteins that make them quickly forming thrombus than mature platelets, potent to form bigger thrombus, and increase the risk of Major Adverse Cardiac Events (MACE). HEART score is a risk stratification for possible NSTE-ACS, which can predict MACE. The study aimed to analyze the correlation between the percentage of reticulated platelets and HEART score. 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 the Emergency Department of Dr. Hasan Sadikin Hospital. These subjects were assessed for the HEART score and RP 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, absolute 3 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 test between RP percentage and HEART score with a 95% confidence interval using Spearman's correlation test showed a significant positive correlation with moderate strength (p < 0.001 and r=0.475). The percentage of RP in this study was in the normal range. However, there was a significant positive correlation with moderate strength between the percentage of RP and HEART scores in patients with suspected non-ST elevation acute coronary syndrome.
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

Abstract

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 Slope 2 in Clot Waveform Analysis of Activated Partial Thromboplastin Time with Factor VIII Activity in Hemophilia A Raissa Yolanda; Delita Prihatni; Coriejati Rita; Dewi Kartika Turbawaty
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1869

Abstract

Hemophilia A is an inherited factor VIII deficiency disease, related to X chromosome. Diagnosis of Hemophilia A is made based on Factor VIII assay. Nowadays, Hemophilia A therapy is by giving factor VIII concentrate, so that monitoring of this therapy must be done by examine Factor VIII activity, but examination of Factor VIII activity is currently still limited in facilities and quite expensive. One of activated partial thromboplastin time (aPTT) optical methods can provide information about every stage of coagulation through clot waveform analysis. Factor VIII activity can describe in slope 2 of clot waveform analysis, which deficiency of factor VIII will cause slope 2 slighter than normal, because the clot form is not optimal and the light transmission recorded at clot waves do not decrease maximally. The aim of this study was to analyze the correlation between slope 2 on the clot waveform analysis of the optical method on aPTT test with Factor VIII activity in hemophilia A subjects. This was a correlative observational study cross sectional study, conducted at Hasan Sadikin General Hospital Bandung in August 2018-September 2019. The subjects were member of Hemophilia A sufferers of West Java Hemophilia Society. The research subjects were assesed for Factor VIII activity and optical method of aPTT. Slope 2 calculated from the clot waveform analysis that formed in aPTT examination. This study involved 43 subjects, with a median age of 6 years, an age range of 1-45 years, and 51.2% of patients aged 6-17 years. The results of Factor VIII activity in this study had a median 0% with a range 0-25.9%, and the value of slope 2 had a median 1.0%T/sec with a range 0.5-3.5%T/sec. The correlation test between slope 2 and Factor VIII activity with 95% confidence interval using Spearman's correlation test showed very strong positive correlation which statistically significant (r = 0.854 and p <0.001). Conclusion: there was a statistically significant very strong positive correlation between slope 2 on the clot waveform analysis of aPTT optical method test with the activity of Factor VIII in Hemophilia A.
The Combination of NLR and D-dimer as Predictor Instrument for the Severity of COVID-19 Shofia Widya Murti; Delita Prihatni; Adhi Kristianto Sugianli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1998

Abstract

Coronavirus Disease-19 (COVID-19) is caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). In severe cases, the immune response may cause a cytokine storm. Neutrophil Lymphocyte Ratio (NLR) and D-dimer are parameters that may be used to predict the severity of COVID-19. This study aims to determine the diagnostic validity of the combination of NLR and D-dimer on the severity of COVID-19 patients. The study population was hospitalized COVID-19 patients whose diagnosis were confirmed by real time-PCR. This was a retrospective cross-sectional study. The cut-off value was based on the Area Under Curve (AUC) of the Receiver Operator Characteristic Curve (ROC) analysis and the combination of NLR and D-Dimer validity was tested against the severe and non-severe COVID-19 groups by assessing sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), positive Likelihood Ratio (LR+) and negative Likelihood Ratio (LR-). There were 1,314 subjects. Seven hundred and forty-four were in the severe group, 570 in the non-severe group. The combination of NLR > 4.02 and D-dimer > 1.12 mg/L on the severity of COVID-19 showed a sensitivity value of 70.8%, specificity 98.3%, PPV 98.1%, NPV 72.1%, LR+ 40.38 and LR- 0.30. The combination of NLR >4.02 and D-dimer >1.12 mg/L for the severity of COVID-19 showed high specificity and PPV (98.3% and 98.1%). This was also supported by the LR+ value, which indicates that if NLR > 4.02 and D-dimer > 1.12 mg/L, it may cause severe COVID-19 by 40.38 times compared to NLR ≤4.02, and D-dimer ≤1.12 mg/L. The combination of NLR and D-Dimer can be used to predict the severity of COVID-19.
Perbedaan Parameter Eritrosit Dan Retikulosit Pada Pasien Talasemia Beta Minor Dan Anemia Defisiensi Besi Ringan Roes, Bellya Affan; Prihatni, Delita; Tristina, Nina
Indonesian Journal of Health Science Vol 4 No 1 (2024)
Publisher : PT WIM Solusi Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54957/ijhs.v4i1.749

Abstract

Beta thalassemia and iron deficiency anemia (IDA) are most common microcytic hypochromic anemia. It is difficult to distinguish minor β thalassemia from mild iron deficiency anemia only by clinical findings and routine hematology examinations, it requires confirmatory tests which are limited in availability and relatively expensive. The presence of additional erythrocyte and reticulocyte parameters (RDW-CV, RBC-He, %MicroR, %Hypo-He, Ret-He, IRF) in hematology analysers are expected to be screening parameters in differentiating minor β thalassemia from mild IDA. The purpose of this study was to determine the differences in the values ​​of RDW-CV, RBC-He, %MicroR, %Hypo-He, Ret-He, and IRF between minor β thalassemia patients and mild IDA.              This study was an observational, analytical, comparative, with a cross sectional design. Research was conducted at RSU Kota Tangerang Selatan from July to October 2020. Subjects were children who went to an outpatient clinic/medical check-up, or with laboratory data of minor β thalassemia or had β thalassemia families. Samples were analysed using Sysmex XN 1000. Statistical analysis was performed by the independent t test for normally distributed data and the Mann Whitney difference test for abnormally distributed data.     The RBC-He and Ret-He values ​​were lower in minor β thalassemia than mild IDA and significantly different with p value 0.005 and 0.004, respectively. The %MicroR and %Hypo-He values were higher in minor β thalassemia than mild IDA and significantly different with p values ​ 0.000 and 0.003, respectively. The RDW-CV and IRF values ​​were higher in minor β thalassemia than mild IDA but were not significantly different with the p value 0.076 and 0.528 respectively.     Conclusion: RBC-He and Ret-He values which reflect hemoglobin content in erythrocytes and reticulocytes ​​were lower in minor β thalassemia patients compared to mild IDA and were significantly different. The values ​​of %MicroR and %Hypo-He which reflect microcytic and hypochromic in erythrocyte population were higher in patients with minor β thalassemia than mild IDA and were significantly different. RDW-CV which reflects variation size of erythrocytes and IRF which reflects erythropoiesis activity and ineffective erythropoiesis were higher in patients with minor β thalassemia than mild IDA and were not significantly different.
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