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Riadi Wirawan Riadi Wirawan
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Paroxysmal nocturnal haemoglobinuria with dysphagia. A case report Riadi Wirawan, Riadi Wirawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 36, No 2 (2004)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (112.386 KB)

Abstract

We reported a case of a 32 year old male with diagnosis thalassaemia and dysphagia who had been hospitalized four times at two different private hospitals. The chief complaints were weakness, brownish red discoloration of urine at night until morning and dysphagia. Physical examination revealed hepatosplenomegaly. The laboratory findings were normocytic normochromic anaemia, pancytopenia, reticulocytosis, hyperactive erythropoiesis, decreased NAP score, positive Hams test and sugar water test. These findings were in accordance with intravascular haemolytic anaemia caused by PNH. Dysphagia in this case is one of clinical manifestation of PNH. We also found disorder of liver function test such as increased transaminase activity and gGT which may be caused by cholestasis, which should be confirmed by USG.Key words : intravascular haemolytic anaemia - dysphagia - haemoglobinuria - cholestatis - pancytolemia
Accelerated phase of chronic mylogenous leukemia in paediatric with metabolic acidosis and poor nutritional status. A case report Riadi Wirawan, Riadi Wirawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (170.136 KB)

Abstract

We reported a case of a twelve year old girl diagnosed as chronic myelogenous leukemia (CML), metabolic acidosis and poor nutrional status. The chief complaints were bulging abdomen, without abdominal pain, nausea and vomiting, accompanied by episodic pain in the lower extremities and buttocks without swelling or redness. Physical examination revealed hepatosplenomegaly, multiple lympadenopathy, body weight for age 54% of P50 and body weight for height 60% of P50; under P65. The laboratory findings were normochromic normocytic anemia, leucocytosis with shift to the left, myelocyte and neutrophil domination, thrombocytosis, hypercellular bone marrow with hyperactive granulopoiesis and megakaryocyte, erythropoiesis and NAP score decreased and the result of blood gas analysis was partially compensated metabolic acidosis with hypoxemia.Key words: Chronic myelogenous leukemia - metabolic acidosis - poor nutritional status - infection - hydroxyurea, cytosar 
Reference value of quantitative. examination of urine sediment using Shih-Yung (S-Y) system Riadi Wirawan, Riadi Wirawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 36, No 3 (2004)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (174.074 KB)

Abstract

Background: Conventional urine sediment examination was reported semiquantitatively, Shih-Yung system was quantitative and standaridizeci method.Objective: To evaluate urine sediment examination using Shih-Yung systems and to determine the reference value.Material and methods: Normal and pathologic urine from patients who have renal and urinary tract disorders, control material for urine microscopic examination Kova-TrolTm I and also urine from 120 healthy men and 120 healthy women.Results: Within run precision using normal urine, pathologic urine, and Kova-TrolTm I yielded a different coefficient of variation (CV) for small and large amount urine sediment component. Laboratory agreement between two observer using Kappa test were >80% for each urine sediment component. Reference values of urine sediment component were as follows: red cells 0-2/4, white cells 0-4/4, hyalin cast 0/ pL, epithelial cell for men 0-1/4 and epithelial cell for women 0-9/4.Conclusion: a relative big CV for small amount urine sediment component and vice versa. Reference values of urine sediment component were as follows: red cells 0-2/4, white cells 0-4/4, hyalin cast 0/epithelial cell for men 0-1/4 and epithelial cell for women 0-9/4. Shih-Yung system yielded a good laboratory agreement between two observers using Kappa test.Key words: urinalysis - urine sediment - quantitative examination - S-Y system - normal value
Accelerated phase of chronic mylogenous leukemia in paediatric with metabolic acidosis and poor nutritional status. A case report Riadi Wirawan Riadi Wirawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (170.136 KB)

Abstract

We reported a case of a twelve year old girl diagnosed as chronic myelogenous leukemia (CML), metabolic acidosis and poor nutrional status. The chief complaints were bulging abdomen, without abdominal pain, nausea and vomiting, accompanied by episodic pain in the lower extremities and buttocks without swelling or redness. Physical examination revealed hepatosplenomegaly, multiple lympadenopathy, body weight for age 54% of P50 and body weight for height 60% of P50; under P65. The laboratory findings were normochromic normocytic anemia, leucocytosis with shift to the left, myelocyte and neutrophil domination, thrombocytosis, hypercellular bone marrow with hyperactive granulopoiesis and megakaryocyte, erythropoiesis and NAP score decreased and the result of blood gas analysis was partially compensated metabolic acidosis with hypoxemia.Key words: Chronic myelogenous leukemia - metabolic acidosis - poor nutritional status - infection - hydroxyurea, cytosar 
Paroxysmal nocturnal haemoglobinuria with dysphagia. A case report Riadi Wirawan Riadi Wirawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 36, No 2 (2004)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (112.386 KB)

Abstract

We reported a case of a 32 year old male with diagnosis thalassaemia and dysphagia who had been hospitalized four times at two different private hospitals. The chief complaints were weakness, brownish red discoloration of urine at night until morning and dysphagia. Physical examination revealed hepatosplenomegaly. The laboratory findings were normocytic normochromic anaemia, pancytopenia, reticulocytosis, hyperactive erythropoiesis, decreased NAP score, positive Ham's test and sugar water test. These findings were in accordance with intravascular haemolytic anaemia caused by PNH. Dysphagia in this case is one of clinical manifestation of PNH. We also found disorder of liver function test such as increased transaminase activity and gGT which may be caused by cholestasis, which should be confirmed by USG.Key words : intravascular haemolytic anaemia - dysphagia - haemoglobinuria - cholestatis - pancytolemia
Reference value of quantitative. examination of urine sediment using Shih-Yung (S-Y) system Riadi Wirawan Riadi Wirawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 36, No 3 (2004)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (174.074 KB)

Abstract

Background: Conventional urine sediment examination was reported semiquantitatively, Shih-Yung system was quantitative and standaridizeci method.Objective: To evaluate urine sediment examination using Shih-Yung systems and to determine the reference value.Material and methods: Normal and pathologic urine from patients who have renal and urinary tract disorders, control material for urine microscopic examination Kova-TrolTm I and also urine from 120 healthy men and 120 healthy women.Results: Within run precision using normal urine, pathologic urine, and Kova-TrolTm I yielded a different coefficient of variation (CV) for small and large amount urine sediment component. Laboratory agreement between two observer using Kappa test were >80% for each urine sediment component. Reference values of urine sediment component were as follows: red cells 0-2/4, white cells 0-4/4, hyalin cast 0/ pL, epithelial cell for men 0-1/4 and epithelial cell for women 0-9/4.Conclusion: a relative big CV for small amount urine sediment component and vice versa. Reference values of urine sediment component were as follows: red cells 0-2/4, white cells 0-4/4, hyalin cast 0/epithelial cell for men 0-1/4 and epithelial cell for women 0-9/4. Shih-Yung system yielded a good laboratory agreement between two observers using Kappa test.Key words: urinalysis - urine sediment - quantitative examination - S-Y system - normal value
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