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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Mansyur Arif
Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo Hospital, Makassar
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Analysis of Erythrocyte Indices and Reticulocyte Hemoglobin Equivalent in Iron Deficiency Anemia on Treatment Agnes Theresia Motulo; Rachmawati Muhiddin; Nadirah Rasyid Ridha; Mansyur Arif; Agus Alim Abdullah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 2 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i2.1991

Abstract

Assessment of treatment response is needed in the management of iron deficiency anemia (IDA). This study aims to analyze erythrocyte indices (MCH, MCV, MCHC) and Ret-He as indicators of IDA diagnosis and treatment response. A prospective cohort study in children ages 2-18 years old in orphanages throughout Makassar. Grouped into normal group and therapy group, consisting of IDA and iron deficiency groups. Elemental iron therapy 3mg/kg/day was given. Levels of MCV (fl), MCH (pg), MCHC (g/dL), and Ret-He (pg) were measured before and on the 8th day of therapy. The normality test of numerical variable data used the Kolmogorov-Smirnov test. The statistical test used the Mann-Whitney test, Wilcoxon Signed Rank test, and the Kruskal-Wallis test.  Diagnostic value and cut-off determination using ROC curve analysis. Test results were significant if p<0.05. The sample consisted of 40 subjects each in both normal and therapy groups. The therapy group was divided into 7 IDA and 33 iron deficiency. ROC IDA curve on MCV obtained a cut-off of 76 fl, a sensitivity of 100%, a specificity of 95%, NPP of 77.8%, NPN of 100%, MCH obtained a cut-off of 25 pg, a sensitivity of 100%, 97.5% specificity of 97.5%, NPP of 87.5%, NPN of 100%, Ret-He obtained cut-off 29 pg, sensitivity of 100%, specificity of 95%, NPP of 77.5%, NPN of 100%. MCV levels increased by 7.3% (p<0.05) while Ret-He increased by 19.6% (p<0.05) after therapy. The ROC curve coordinate on IDA showed that cut-off levels of MCV 76 fl, MCH 25 pg, and Ret-He 29 pg provided optimal sensitivity and specificity. Increasing MCV after therapy described increasing levels in erythrocyte and hematocrit synthesis. Increasing Ret-He after therapy described improving erythropoiesis quality. MCV, MCH, and Ret-He as indicators of diagnosing IDA. MCV and Ret-He monitor the success of IDA treatment response.
Prognostic Analysis of NLR, PLR, and, LMR in Osteosarcoma at Dr. Wahidin Sudirohusodo Hospital Febriani Helda Pongbala; Uleng Bahrun; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2126

Abstract

Osteosarcoma is a primary pediatric bone malignancy with an annual incidence of 5.6 cases per million children under the age of 15. The high mortality rate leads to necessary for prognostic biomarkers of the disease. NLR, PLR, and LMR can be considered as prognostic predictors of osteosarcoma patients. This study aimed to determine the difference and correlation between NLR, PLR, and LMR based on grade and outcome in osteosarcoma patients. The study used medical record data from 122 osteosarcoma patients at Dr. Wahidin Sudirohusodo Hospital, Makassar. Samples were grouped by stage according to Enneking criteria (Grade I, II, and III) and by outcome (deceased and not deceased), then analyzed based on NLR, PLR, and LMR values using the Kruskal-Wallis test and the Mann-Whitney test (significant if p<0.05). There was a significant difference in NLR, PLR, and LMR values by grade, (p=0.05). There was a significant difference in the value of NLR, and LMR based on output (p=0.00), but not in PLR (p=0.954). There was a correlation between the values of NLR, PLR, and LMR and the stage of osteosarcoma (p=0.05). Based on the outcome, a correlation with the NLR and LMR values was obtained (p=0.00), but there was no correlation with the PLR value (p=0.955). Cut-off NLR, PLR, and LMR were 4.43; 0.21; and 0.44, respectively, with sensitivity of 76%, 56%, and 76% and a specificity of 76%, 63.9%, and 68%, respectively. There were differences in NLR, PLR, and LMR values based on the stage and outcome of osteosarcoma.  Higher NLR, PLR, and LMR values will lead to a higher stage of osteosarcoma and a worse outcome. Cut-off NLR, PLR, and LMR optimal for distinguishing stage of osteosarcoma were 4.43; 0.21, and 0.44, respectively.
Co-Authors Agnes Theresia Motulo Agus Alim Abdullah Febriani Helda Pongbala Nadirah Rasyid Ridha, Nadirah Rasyid Rachmawati Muhiddin Uleng Bahrun