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Objective: To present a case of rare secondary chronic immune thrombocytopenia in diffuse large B-cell lymphoma. Methods: A case of secondary ITP associated with diffuse large B-cell lymphoma (DLBCL) in a 58-year-old woman suffering from hemorrhagic tendencies that was refractory to conventional treatments of ITP was reported. This case is a rarity because there are not many cases of secondary chronic ITP due to DLBCL have been reported to date. Results: A 58-year-old woman was diagnosed with ITP around 11 months before she was admitted to the Emergency Room with bleeding. Previous treatment with steroid and azathioprine was only temporarily effective. During the course of treatment, splenomegaly and lymphadenopathy were identified, but lymph node biopsy was delayed by the thrombocytopenia. The drug was then replaced to the eltrombopag, which showed good response. However, the patient had to undergo splenectomy because of the mechanical effect of splenomegaly, with the biopsy result showed DLBCL. Immune thrombocytopenia then went into a complete remission after splenectomy. Conclusion: In cases of ITP that are refractory to conventional treatments, a thorough search for secondary ITP might be helpful, even if no underlying disorder is detected at the initial presentation.

Objective: To determine the mechanism of erythropoiesis that led to anemia using the Immature Reticulocyte Fraction (IRF) parameter in various clinical phases of dengue fever. Methods: This study was a comparative analytical research using secondary data derived from the Dengue-associated Endothelial Cell Dysfunction and Thrombocyte Activation (DECENT) research. The study was performed at Dr. Hasan Sadikin Hospital Bandung, Indonesia from March 2011 to March 2012. Patients were grouped into fever, critical, recovery, and convalescent phases and a healthy control was established. Data collected were analyzed using the Kolmogorov-Smirnov normality test, followed by Friedman test and Mann-Whitney post hoc test. Results: There were 244 subjects participating in this study. The median IRF for all subjects was 4.8% with an IQR of 2.4-8.1%. The values of Immature Reticulocyte Fraction in fever-phase, critical-phase, recovery-phase, convalescent-phase and healthy-control were 1.8% (IQR of 0.5-2.85%), 3.6% (IQR of 1.8-5.0%), 7.05% (IQR of 4.08-11.85%, 7.3 % (IQR of 3.95-9.3%) and 4.1% (IQR of 2.2-6.6%), respectively. There was a significant difference in IRF between groups (p

The aim of this study was to evaluate the effect of Indian Pennywort methanol extract on carbontetrachloride (CCl )- 4 induced hepatitis rats model, compared with vitamin E. Parameters used were levels of serum glutamic pyruvic transaminase (SGPT), malondialdehide (MDA), and extent of liver necrosis. Experimental laboratory study was conducted at Pharmacology Laboratory Hasan Sadikin Hospital Bandung, October 2009, with randomized complete design on 40 rats divided into 8 subgroups. The level of SGPT was analyzed by enzymatic method, MDA level was analyzed by Wilbur method. The extent of liver necrosis was analyzed by hematoxylin eosin staining. The results, the extract, if given pre-induction of hepatotoxicity, can significantly prevent the increase of SGPT levels and the extent of necrosis (p ≤0.05), but can't significantly prevent the increase of liver tissue MDA levels (p >0.05). Postinduction, the extract can significantly reduce the SGPT levels, liver tissue MDA levels, and the extent of liver necrosis (p≤0.05). Therefore, effect of the Indian Pennywort extract is better than vitamin E, and can act as hepatoprotector