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All Journal Althea Medical Journal Universa Medicina Neurona
Lelani Reniarti
Faculty of Medicine Padjadjaran University/ Dr. Hasan Sadikin Hospital, Bandung
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Burden of Pediatric Cancer Treatment: Results of Online Pediatric Cancer Registry Prototype 1 at A Third Referral Hospital in Indonesia Sari, Nur Melani; Reniarti, Lelani; Suryawan, Nur; Susanah, Susi; Wahyudi, Kurnia
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (606.214 KB) | DOI: 10.15850/amj.v4n3.1204

Abstract

Background: Despite the impressive progress of high-income countries, childhood cancer survival remains low in low and middle-income countries. Cancer is yet to be considered as a significant public health issue which has implicate only few pediatric cancer registry has been well established. The study aimed to describe the burden of pediatric cancer treatment in a third referral hospital in Indonesia through pediatric cancer registry.Methods: A-three-year retrospective analysis of 15 pediatric cancer diagnosed in children aged under 14 years was conducted at Dr Hasan Sadikin General Hospital, Bandung.  Data were extracted from Online Bandung Pediatric Cancer Registry Prototype 1 and analyzed for age, gender, type of cancer. The outcomes were classified as treatment abandonment, treatment refusal, interrupted treatment, death during treatment, and completed treatment.Results: Seven-hundred and seventy-three children, 452 males and 321 females, were diagnosed with 15 types of malignancies.  Peak incidence for each malignancy was different: at a young age was found in retinoblastoma and hepatoblastoma (mean; 3yo) while at adolescence in bone tumor and chronic myelocytic leukemia (9.1; 10 yo respectively). Distribution of the foremost malignancies recorded was: acute lymphoblastic leukemia (44.5%), retinoblastoma (15.2%), and non-Hodgkin lymphoma (8.9%). The cancer cure rate was very low (9.5%), treatment abandonment was still high (41.7%) and most patients died (27.8%) in the course of therapy either from advanced disease, infection, or late presentation. Meanwhile, 167 patients still continued the interrupted treatment.Conclusions: Cancer management is the burden for hospital, however the general outcome is very poor. 
High ferritin in homozygous and heterozygous β-thalassemia tends to decrease oxidative stress levels Maskoen, Ani Melani; Reniarti, Lelani; Sumantri, Nur Imaniati; Sahiratmadja, Edhyana
Universa Medicina Vol 37, No 2 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.97-104

Abstract

BackgroundIneffective erythropoiesis and multiple blood transfusions may cause iron overload, leading to high level of ferritin in β-thalassemia patients. Iron has the ability to catalyze the production of reactive oxygen species (ROS), which can be prevented by an adequate activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx). The aim of this study was to explore the association between high ferritin levels and oxidative stress among β-thalassemia patients by measuring SOD and GPx levels. MethodsThis was a cross sectional study among β-thalassemia major patients. Ferritin, SOD, and GPx were measured and compared between β-thalassemia patients with homozygous IVS1nt5 and heterozygous IVS1nt5/HbE mutations, which were the most prevalent mutations found in our previous study. The Spearman correlation test was used to analyze the data. ResultsThe ferritin levels in all β-thalassemia major patients were very high (range: 791-12,340 µg/L). However, no significant differences were observed (p=0.318) between homozygous IVS1nt5 (n=45) compared to heterozygous IVS1nt5/HbE (n=13). The oxidative stress markers SOD and GPx were not significantly different between homozygous IVS1nt5 and heterozygous IVS1nt5/HbE (p=0.450 and p=0.323, respectively). The correlations between ferritin and SOD and GPx oxidative stress levels were not significant in both homozygous IVS1nt5 and heterozygous IVS1nt5/HbE mutations. ConclusionHigh ferritin levels in β-thalassemia patients tend to decrease the GPx level in all thalassemia patients and SOD level in half of the patients, indicating that GPx and SOD may play a role in the occurrence of oxidative stress among thalassemia patients. The mechanism of oxidative stress in thalassemia needs to be further explored.
Five-Year Data of Clinical Characteristics and Laboratory Findings of Hospitalized Hemophilic Patients in Dr. Hasan Sadikin General Hospital Marlina, Dina; Reniarti, Lelani; Veronica, Fifi
Althea Medical Journal Vol 3, No 4 (2016)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (170.054 KB)

Abstract

Background: Hemophilia A has the highest incidence, more than 80% of 172.323 cases worldwide in 2012. It is stated that clinical characteristics of hemophilia A is worse than others, so it is required to prove and to know further about the clinical characteristics and severity likelihood in all hemophilic patients in order to prevent re-bleeding and re-injury and also for a better medical response.Methods: A retrospective cross-sectional study was carried out to 43 medical records of hospitalized hemophilic patients from 2009 to 2013 in Dr Hasan Sadikin General Hospital. The inclusion criteria were a complete patient identity (name, age, sex), written chief complaint, complete physical examination (bleeding, edema, hematoma, hemarthrosis, anemic symptoms) and laboratory test results (factor level, hemoglobin, hematocrit, platelet and Activated Partial Thromboplastin Time). The data was collected from August‒October 2014, analyzed and presented using frequency distribution.Results: Most of the patients were 5-10 years old, male and had hemophilia A. The most common complaint was external bleeding, followed by edema. From 43 patients, 38 (88%) cases were classified as severe factor deficiency, had mild to severe anemia, however the platelet count in most of the cases was in normal value. About 91% cases had prolonged Activated Partial Thromboplastin Time in moderate to severe level.Conclusions: Similar with other studies worldwide, most of the hospitalized hemophilic patients have hemophilia A. Most of the patents has moderate to severe bleeding with laboratory test result between moderate to severe level as well. [AMJ.2016;3(4):605–9]
HUBUNGAN KADAR HEMOGLOBIN DAN FERITIN DENGAN GAMBARAN KONDUKSI SARAF PADA ANAK TALASEMIA BETA MAYOR Dewi, Windy Krisanti Kusuma; Gamayani, Uni; Lailiyya, Nushrotul; Reniarti, Lelani; Sekarwana, Nanan
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 35 No 1 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i1.42

Abstract

    CORRELATION BETWEEN HAEMOGLOBINE AND FERRITIN LEVEL WITH NERVE CONDUCTION STUDY IN CHILDREN WITH BETA THALASSEMIA MAJORABSTRACTIntroduction: Beta thalassemia major is inherited hemoglobin synthesis disorder found in thalassemia belt, including Indonesia. Peripheral neuropathy is one of its underdiagnosed neurological complications results in poor management of the patients.Aims: To identify correlation between hemoglobin and ferritin serum with Nerve conduction study (NCS) in Beta thalassemia major patients.Methods: This was a cross-sectional study involving children with beta thalassemia major aged 8-14 years, who regularly underwent blood transfusions in Hasan Sadikin Hospital, Bandung. Nerve conduction study of motor and sensory nerves of all limbs were conducted to the patients. Data was analyzed using Spearman’s correlation analysis.Results: Fifty subjects were included in this study with the mean hemoglobin level (SD) of 6.99 (0.87)g/dL and the mean blood ferritin level (SD) of 3.925 (1.993)μg/L. Based on NCS, most of the subjects had polyneuropathy and 46.94% had axonal demyelinating lesions in sensory and motor nerves. Among patients with neuropathy, there was a statistically significant negative correlation  between mean hemoglobin level and the numbers of the abnormal  nerves and also a statistically significant positive correlation between mean blood ferritin level and the numbers of the abnormal nerves.Discussion: The lower ferritin serum level, the less nerve involved based on NCS.Keyword: Beta thalassemia, ferritin, hemoglobin, nerve conduction study, neuropathyABSTRAKPendahuluan: Talasemia beta mayor merupakan suatu kelainan sintesis hemoglobin yang herediter yang banyak ditemukan di wilayah tropis, termasuk Indonesia. Salah satu komplikasinya adalah neuropati perifer yang sering tidak terdiagnosis, sehingga penyandangnya tidak mendapatkan tata laksana yang adekuat.Tujuan: Mengetahui hubungan antara kadar hemoglobin dan feritin serum dengan gambaran konduksi saraf (nerve conduction study/NCS) pada penyandang talasemia beta mayor.Metode: Studi potong lintang terhadap penyandang talasemia berusia 8-14 tahun yang rutin menjalani transfusi darah di RSUP Dr. Hasan Sadikin, Bandung. Dilakukan pemeriksaan NCS motorik dan sensorik pada keempat ekstremitas. Data dianalisis menggunakan uji korelasi Spearman.Hasil: Diperoleh 50 subjek dengan rerata kadar hemoglobin 6,99+0,87g/dL dan kadar feritin serum 3.925+1.993μg/L. Berdasarkan pemeriksaan NCS, sebagian besar subjek mengalami polineuropati yang 46,94% di antaranya berupa gambaran demielinasi aksonal sensorik motorik. Pada subjek dengan neuropati perifer didapatkan korelasi negatif yang bermakna antara kadar hemoglobin dengan jumlah keterlibatan saraf pada NCS dan korelasi positif yang bermakna antara kadar feritin serum dengan jumlah keterlibatan saraf pada NCS.Diskusi: Semakin rendah kadar feritin serum, maka semakin sedikit jumlah saraf yang terlibat pada NCS, dan sebaliknya.Kata kunci: Feritin, hemoglobin, nerve conduction study, neuropati, talasemia beta mayor
Co-Authors Ani Melani Maskoen Dewi, Windy Krisanti Kusuma Dina Marlina, Dina Edhyana Sahiratmadja Fifi Veronica Kurnia Wahyudi, Kurnia Lailiyya, Nushrotul Nanan Sekarwana Nur Melani Sari Sumantri, Nur Imaniati Suryawan, Nur Susi Susanah Uni Gamayani, Uni