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

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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.
Validity Test For C-Reactive Protein and Ferritin Level in Moderate and Severe Covid-19 Patients Kurnia, Chyntia Putriasni; Wasilah, Fajar; Lismayanti, Leni
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.3025

Abstract

Mild, moderate, severe, and critical COVID-19 are associated with hyperinflammation. The CRP and ferritin are acute phase proteins that marks incidence of inflammation and used as the paramaters of hyperinflammation. This study aimed to determine the validity of CRP and ferritin level examination in moderate and severe COVID-19 since the time of admission. This was a cross-sectional analytical retrospective study with on moderate and severe COVID-19 patients admitted to Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of March 2020 to December 2020. The CRP and ferritin levels were obtained since the beginning of admission to the fourth day since admission on patients without any history of anemia. Subjects in this study were divided into moderate and severe COVID-19 groups based on the 3rd edition of COVID-19 Prevention and Control Guideline issued by the Ministry of Health Republic of Indonesia. Each group consisted of 30 subjects. The cut-off value was 7.65 mg/dL (AUC 0.698) for CRP and 963.1 mcg/L (AUC 0.938) for ferritin. The validity of ferritin vs CRP were reflected respectively as follows:  93.3% vs 76.7% sensitivity; 80.0% vs 63.3% specificity; 82.4% vs 67.6% PPV; and 92.3% vs 73.1% NPV. The validity of ferritin was proven to be superior as it  significantly increases since day one, persisted longer and reaches its peak on  the16th day. Meanwhile, CRP increases within 6-8 hours and reaches its peak within 48 hours after inflammation, then declines soon afterwards.
Snake-Bite with Disseminated Intravascular Coagulation (DIC) and Stage II Hypertension Hendra Subroto; Leni Lismayanti
Journal of Medicine and Health Vol 1 No 5 (2017)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v1i5.544

Abstract

Snake-bite is an important medical emergency case and caused of many hospitaladmission especially in the rural area, forests, plantations and swamps. Despite its importance,there have been fewer proper data of snake-bite incidence in Indonesia. World HealthOrganization estimate that at least 421,000 envenomings and 20,000 deaths from snakebitesoccur each year, especially in South and South East Asia and sub-Saharan Africa. The authorsreport a case of a 76-year-old man came to Hasan Sadikin Hospital with chief complaint woundin his right hand and right forearm from snake-bite. Snake-bites can cause DIC because thevenom activates the coagulation system and cause fibrinolysis which occurs in less than 24hours. Laboratory results, we found abnormalities such as anemia, thrombocytopenia,hypofibrinogenemia, and increased levels of D-dimer. Patients were treated for 8 days and thenallowed to go home. Snake-bite is an occupational disease of farmers, plantation workers,herdsmen, fishermen, other. Snake bite cases require prompt and comprehensive managementso as to minimize the possibility of disability and death.Keywords: snake bite, DIC, hypertension
Crossmatch Results After Repeated Transfusions Horian, Erinca; Lismayanti, Leni; Sugianli, Adhi Kristianto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 3 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i3.2349

Abstract

Patients with thalassemia, chronic kidney disease, hematologic and non-hematologic malignancies may require repeated transfusions. Repeated transfusions can have a detrimental effect, leading to the formation of alloantibodies and/or autoantibodies. These antibodies can cause incompatible crossmatch results. This study aims to identify the clinical characteristics of patients with incompatible crossmatch results after repeated transfusions, to ensure safe transfusions. This study is a cross-sectional, observational descriptive study conducted at Dr. Hasan Sadikin General Hospital from January to December 2022. Patients were included if they had received more than one transfusion within the past year, defined as 'repeated transfusions'. The following data were collected: age, gender, blood type, diagnosis, quantity of blood bags, total number of transfusions, interval between transfusions, history of incompatibility, and Coombs Test. The data were obtained through the laboratory information system and from blood request forms in the Blood Service Unit. Out of 2285 subjects receiving repeated transfusions, 38.1% experienced crossmatch incompatibility. The majority (91.2%) of these cases were minor. Crossmatch incompatibility occurred more frequently in subjects under the age of 15 (22.6-23.3%) and those with diagnosis of thalassemia (25.6-27.3%). Most subjects with minor crossmatch incompatibility had a history of receiving more than four blood bags (51.9-60%), an interval between transfusions of four weeks or less (92.2-92.8%), and a history of previous incompatibility (72.1-80.5%). The important clinical characteristics of patients with incompatible crossmatch results after repeated transfusions were age, underlying diagnosis, quantity of blood bags, interval between transfusions, and history of previous crossmatch incompatibility.
Comparison of ABO Blood Group Antibody Titers in Elderly and Young Adult Patients Dianawati, Dina Asri; Lismayanti, Leni; Wasilah, Fajar
Majalah Kedokteran Bandung Vol 57, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.4066

Abstract

Immunosenescence in the elderly decreases their antibodies, which may lead to weaker degree of agglutination formation that potentially causes ABO discrepancies. This may lead to misinterpretation of blood group in this group. This study aimed to determine whether there are differences in antibody titer levels and degree of agglutination formed when examining ABO blood groups in the elderly as compared to young adults. This was a cross-sectional study employing analytical observational methods. Data were collected prospectively from the Blood Services Unit of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between May 2022 and July 2022. The subjects included were 42 elderly participants and 42 young adults, grouped accordingly. The ABO blood typing was performed using the slide method, while anti-A and anti-B titers were measured by serial two-fold dilution using the tube method. A significant difference in ABO blood group antibody titer levels was observed between elderly and young adult groups (median: 6 vs 64, p<0.001). Antibody titers were lower in the elderly across blood groups A (median: 8 vs 64, p<0.001), B (median: 8 vs 64, p<0.001), and O (median: 4 vs 64, p<0.001). The degree of agglutination was lower in the elderly (2+) compared to young adults (4+). On average, antibody titers in elderly individuals were approximately tenfold lower than those in young adults across all three blood groups. The reduced degree of agglutination further supports the diminished antibody response in the elderly group.
Correlation of odontogenic infection severity score with C-reactive protein levels on patients with odontogenic infection in Dr Hasan Sadikin General Hospital Bandung Prihandana, Ariyaka Niastya; Yusuf, Harmas Yazid; Nurwiadh, Agus; Lismayanti, Leni
Padjadjaran Journal of Dentistry Vol 33, No 1 (2021): March 2021
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/pjd.vol33no1.21252

Abstract

Introduction:  Head and neck infections commonly caused by spreading odontogenic infection, which able to cause a local and systemic manifestation, from mild to severe complications according to its severity. Assessment of the severity of odontogenic infections is essential to determine the prognosis, assessed through local and systemic parameters. Laboratory examination used to examine the biological marker that indicates the ongoing infection. C-reactive protein (CRP) is a protein synthesised by hepatocytes in response to the body's inflammatory process, including odontogenic infection. This study was aimed to analyse the severity score of odontogenic infections using the CRP levels in patients with odontogenic infections. Methods: An analytic study with a cross-sectional approach was conducted on 30 patients of Dr Hasan Sadikin General Hospital Bandung diagnosed with odontogenic infections, determined by calculations according to Hosmer and Lemeshow. Assessment of the severity score in odontogenic infections and quantitative CRP levels with the Dimension tool was conducted afterwards. Correlation between odontogenic infection severity score and CRP levels was analysed using regression and correlation tests. Results: From 30 subjects, there was found 33.3% with mild severity score, 63.3% moderate score and 3.3% severe score. The mean of the CRP level was significantly increased according to the odontogenic severity scoring category. All research subjects who were examined showed that there was a very strong and significant correlation (p-value<0.05) between the severity of odontogenic infections and CRP levels in odontogenic infection patients with a correlation coefficient r=0.84 (p=0.001). Conclusion: There is a positive correlation between the CRP levels and the severity score of odontogenic infection. The higher the CRP levels, the odontogenic infection will be more severe. Therefore, the CRP level might be considered an additional biomarker in supporting the severity of odontogenic infection in clinical practice.
Correlation Between P-Selectin Level and Platelet Aggregation in Cerebral Venous Sinus Thrombosis Patients Nurmin, Rahmawati; Lismayanti, Leni; Rostini, Tiene; Indrati, Agnes Rengga; Amalia, Lisda
Majalah Kedokteran Bandung Vol 55, No 3 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n3.2777

Abstract

One of the causes of cerebral venous sinus thrombosis (CVST) is platelet hyperactivity. Adhesion and secretion are the beginning of platelet activation, which is indicated by a change in the Platelet-selectin (P-selectin) level. The end result of platelet activation is platelet aggregation. However, it is unknown whether the beginning of platelet activation ends with platelet aggregation. This study aimed to discover the correlation between P-selectin level and platelet aggregation in CVST. This study used a cross-sectional escriptive observational correlative approach. Subjects were the CVST outpatients visiting the Neurology Department of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from July to September 2021. A total of 49 subjects met the inclusion and exclusion criteria. This study used citrate plasma samples for platelet aggregation and serum for P-selectin assessment. Platelet aggregation were assessed using the light transmission platelet aggregation method while P-selectin was assessed using Enzyme-linked immunosorbent assay (ELISA). Platelet aggregation median was 10.6% (range 0.2–82.4%), which reflected normoaggregation. Platelet hyperaggregation were seen in 9 samples (8.4%). Median of P-selectin was 2.4 ng/mL (range 0.1–10.1 ng/mL) which were normal. High P-selectin level was observed in 16 (32.7%) with 4/16 (25%) experiencing platelet hyperaggregation. Statistical analysis showed a weak negative correlation between P-selectin and platelet aggregation (r=-0.012; p=0.467). In conclusion, no correlation is seen between P-selectin and platelet aggregation, which may be due to the fact that platelets are influenced by many factors that are not examined in this study.