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Incidence of Peripheral Neuropathy in Major BetaThalassemia Patients at Hasan Sadikin General Hospital, Bandung, Indonesia Fanny Adhy Putri; Uni Gamayani; Nushrotul Lailiyya; Ramdan Panigoro
Cermin Dunia Kedokteran Vol 46 No 9 (2019): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i9.419

Bakground. Beta major thalassemia is the most common inherited blood disorder worldwide. It can lead to various neurological complications such as peripheral neuropathy. Toronto Clinical Neuropathy Score (TCNS) is helpful for peripheral neuropathy screening especially in diabetes mellitus. Objective. To investigate the prevalence of peripheral neuropathy in beta major thalassemia patient using Toronto Clinical Neuropathy Score (TCNS). Method. A descriptive study on beta major thalassemia patients aged more than 14 years who regularly underwent blood transfusions in Hasan Sadikin General Hospital Bandung, from July to August 2017. Normal TCNS value was < 4, mild neuropathy 5-7, moderate neuropathy 8-10 and severe neuropathy > 10. Results. Sixty subjects met the inclusion criteria, 48.3% were male with the mean (SD) age of 20.7 ± 7.6 years. Mean hemoglobin value was 6.7 ± 0.9 g/dL and median (IQR) blood ferritin serum was 2873 (1900-3859) μg/L. Thirty-two subjects had neuropathy; 19 (31.7%) with mild neuropathy and 13 (21.6%) with moderate neuropathy. Conclusion. The incidence of peripheral neuropathy in patients with thalassemia according to TCNS score is fairly high. Latar Belakang. Talasemia beta mayor adalah kelainan darah bawaan paling umum di dunia dan dapat menyebabkan berbagai komplikasi, salah satunya neuropati perifer. Toronto Clinical Neuropathy Score (TCNS) dapat digunakan untuk penilaian neuropati perifer terutama pada pasien diabetes melitus. Objektif. Menyelidiki prevalensi neuropati perifer pada pasien talasemia beta mayor menggunakan Toronto Clinical Neuropathy Score (TCNS). Metode. Penelitian ini studi deskriptif skrining menggunakan TCNS pada pasien thalassaemia beta mayor berusia lebih dari 14 tahun yang secara teratur menjalani transfusi darah di Rumah Sakit Umum Hasan Sadikin Bandung, dari Juli hingga Agustus 2017. Nilai TCNS normal adalah <4, neuropati ringan 5-7, neuropati sedang 8-10 dan neuropati berat >10. Hasil. Sebanyak 60 subjek memenuhi kriteria inklusi, 48,3% laki-laki dengan usia rata-rata (SD) 20,7 ± 7,6 tahun. Nilai hemoglobin rata-rata 6,7 ± 0,9 g/dL dan serum ferritin darah median (IQR) adalah 2873 (1900-3859) μg/L. Tiga puluh dua subjek mengalami neuropati; 19 (31,7%) pasien dengan neuropati ringan dan 13 (21,6%) pasien dengan neuropati sedang. Simpulan. Insidens neuropati perifer pada pasien dengan thalasemia menurut skor TCNS cukup tinggi.

Intravenous administration of iron dextran as a potential inducer for hemochromatosis: Development of an iron overload animal model Khristian, Erick; Ghozali, Mohammad; Bashari, Muhammad H.; Purnama, Jeri N.; Irianto, Gunawan; Panigoro, Ramdan; Safitri, Ratu
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1003

Iron overload in transfusion-dependent thalassemia patients represents a significant public health challenge due to its high mortality rate and risks of severe complications. Therefore, developing safe and effective therapeutic modalities for managing iron overload is critical, as current animal models inadequately replicate human conditions. The aim of this study was to investigate the effects of intravenous iron dextran on hepatocyte morphology, liver iron concentration, and serum iron profile changes as a model for hemochromatosis. An experimental design with a post-test-only control group method was conducted using animal models. Fifty rats were used and divided into ten groups, nine received different intravenous doses of iron dextran: 10, 20, 30, 40, 50, 60, 80, 100, and 120 mg/kg body weight (BW) and a control group received no treatment. The results showed that intravenous iron dextran starting at a dose of 10 mg/kg BW caused significant changes in liver iron concentration while starting at 20 mg/kg BW significantly affected hepatocyte morphology, transferrin levels, unsaturated iron binding capacity, serum iron levels, and transferrin saturation. Intravenous iron dextran starting at 40 mg/kg BW resulted significant changes in the level of total iron binding capacity compared to control group. In conclusion, intravenous iron dextran significantly altered hepatocyte morphology, increased liver iron concentration, and modified the serum iron profile, reflecting changes that might be observed in patients with transfusion-dependent thalassemia.

Pengetahuan Tentang Anemia pada Remaja dan Dewasa Muda di Jakarta dan Jawa Barat: Survei Demografi dan Kesehatan Indonesia 2017 Rahardja, Mugia Bayu; Sahiratmadja, Edhyana; Setiawati, Elsa Pudji; Panigoro, Ramdan; Surbakti, Indra Murty
Majalah Kedokteran Indonesia Vol 74 No 2 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.2-2024-392

Introduction: Iron deficiency anemia in developing countries is common. However, knowledge on the etiology of anemia among young adults needs to be further explored, including hemoglobinopathy, since Indonesia is located in the thalassemia belt, harboring 6-10% thalassemia carriers. The study aimed to explore the knowledge about anemia among young adults in Jakarta and the province of West Java. Methods: A descriptive analytical study design using secondary data from the National Demographic and Health Survey 2017 was employed. A questionnaire was distributed to unmarried young adults (n=5389) aged 15-24, including questions about anemia. Knowledge was further compared between places, genders, and age groups. Result: Only 70% of young adults have heard about anemia. However, the knowledge was poor. The definition of anemia was lack of blood (48%), and only 5% stated it was due to iron deficiency. The etiology of anemia was lack of vegetables (21%) and meat (18%) consumption. As a treatment, only 9% mentioned the iron tablets. None mentioned thalassemia carrier as an alternative cause of anemia. Conclusion: Young adults in Jakarta and West Java are poorly informed about anemia. Socialization to increase knowledge about anemia is imperative. Thalassemia carriers need to be introduced among unmarried young adults for better family planning in the future.

Incidence of Peripheral Neuropathy in Major BetaThalassemia Patients at Hasan Sadikin General Hospital, Bandung, Indonesia Fanny Adhy Putri; Uni Gamayani; Nushrotul Lailiyya; Ramdan Panigoro
Cermin Dunia Kedokteran Vol 46 No 9 (2019): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i9.419

Bakground. Beta major thalassemia is the most common inherited blood disorder worldwide. It can lead to various neurological complications such as peripheral neuropathy. Toronto Clinical Neuropathy Score (TCNS) is helpful for peripheral neuropathy screening especially in diabetes mellitus. Objective. To investigate the prevalence of peripheral neuropathy in beta major thalassemia patient using Toronto Clinical Neuropathy Score (TCNS). Method. A descriptive study on beta major thalassemia patients aged more than 14 years who regularly underwent blood transfusions in Hasan Sadikin General Hospital Bandung, from July to August 2017. Normal TCNS value was < 4, mild neuropathy 5-7, moderate neuropathy 8-10 and severe neuropathy > 10. Results. Sixty subjects met the inclusion criteria, 48.3% were male with the mean (SD) age of 20.7 ± 7.6 years. Mean hemoglobin value was 6.7 ± 0.9 g/dL and median (IQR) blood ferritin serum was 2873 (1900-3859) μg/L. Thirty-two subjects had neuropathy; 19 (31.7%) with mild neuropathy and 13 (21.6%) with moderate neuropathy. Conclusion. The incidence of peripheral neuropathy in patients with thalassemia according to TCNS score is fairly high. Latar Belakang. Talasemia beta mayor adalah kelainan darah bawaan paling umum di dunia dan dapat menyebabkan berbagai komplikasi, salah satunya neuropati perifer. Toronto Clinical Neuropathy Score (TCNS) dapat digunakan untuk penilaian neuropati perifer terutama pada pasien diabetes melitus. Objektif. Menyelidiki prevalensi neuropati perifer pada pasien talasemia beta mayor menggunakan Toronto Clinical Neuropathy Score (TCNS). Metode. Penelitian ini studi deskriptif skrining menggunakan TCNS pada pasien thalassaemia beta mayor berusia lebih dari 14 tahun yang secara teratur menjalani transfusi darah di Rumah Sakit Umum Hasan Sadikin Bandung, dari Juli hingga Agustus 2017. Nilai TCNS normal adalah <4, neuropati ringan 5-7, neuropati sedang 8-10 dan neuropati berat >10. Hasil. Sebanyak 60 subjek memenuhi kriteria inklusi, 48,3% laki-laki dengan usia rata-rata (SD) 20,7 ± 7,6 tahun. Nilai hemoglobin rata-rata 6,7 ± 0,9 g/dL dan serum ferritin darah median (IQR) adalah 2873 (1900-3859) μg/L. Tiga puluh dua subjek mengalami neuropati; 19 (31,7%) pasien dengan neuropati ringan dan 13 (21,6%) pasien dengan neuropati sedang. Simpulan. Insidens neuropati perifer pada pasien dengan thalasemia menurut skor TCNS cukup tinggi.

Pengetahuan Tentang Talasemia pada Mahasiswa Kedokteran dan Dokter Umum di Bandung serta Prevalensi Karir β-Thalassemia Sahiratmadja, Edhyana; Wijaya, Michelle Angelica; Widjajakusuma, Anggraini; Maskoen, Ani Melani; Dewantoro, Julius Broto; Panigoro, Ramdan
Majalah Kedokteran Indonesia Vol 70 No 4 (2020): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.70.4-2020-232

Background: Thalassemia major ranks 5th among catastrophic diseases according to the National Health Insurance, BPJS. Health workers are expected to have good knowledge about thalassemia to raise public awareness for thalassemia carrier early detection. Aim: To explore the knowledge about thalassemia among medical students and general practitioners (GPs) in Bandung, and the prevalence of β-thalassemia carrier.Methods: Analytic study was designed using questionnaire to compare knowledge. The prevalence of anemia due to iron deficiency or β-thalassemia carrier was described using Mentzer Index (MCV/RBC) and Shine and Lal index (MCV*MCV*MCH/100). Results: The knowledge about thalassemia among medical students (n597) and GPs (n171) was moderate, however, there was a significant difference; GPs greater than 30 years old had lower knowledge compared to students. Students attended blood examination had better knowledge (p 0.036). Type of anemia among students (7.9%) was different according to Mentzer index vs. Shine and Lal index; iron deficiciency anemia (5.3% % vs. 3.2%) dan β-thalassemia carrier (2.6% vs. 4.7%). Conclusions: Knowledge of thalassemia among medical students and GPs need to be enhanced, since 6-10% of Indonesian population are thalassemia carriers. Further examination is needed to confirm thalassemia carriership.

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