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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

The automatic platelet count sometimes requires confirmation on the peripheral blood smear. Platelet count estimation can also be used for reporting platelet count if an automatic cell counter is not available, with an estimation factor according to the Field Number (FN) of the microscope used. This study aimed to determine the platelet count estimation factor based on peripheral blood smear confirmation using an FN 22 microscope. An observational cross-sectional study was carried out in patients who had routine hematological and peripheral blood smear examinations during September 2021 by determination of platelet count using the automatic cell counter method and an average number of platelet counts per field of view with 100x objective magnification. The estimation factor is the total ratio divided by sample size. The total ratio of 254 samples was 4.086. The platelet count estimation factor was 16, indicating that 1 platelet per field of view was equivalent to 16x103/µL. There was a very strong significant correlation between mean platelet count per field of view and platelet count using the automatic cell counter (p0.750). The field number is the image diameter of the microscope eyepiece. The latest generations of microscope use FN 20 or more, which provides a wider field of view, enabling the observation of more platelets. Factor estimation was used to determine the estimated platelet count on a peripheral blood smear. A big difference between automatic cell counter and peripheral blood smear might indicate pre-analytic, analytic, and post-analytic errors. The platelet count estimation factor based on peripheral blood smear confirmation using the FN 22 microscope was 16. Each laboratory needs to determine the estimation factor according to the FN microscope used.

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Knowing the severity of COVID-19 is important during a pandemic. Measurement of Lactate Dehydrogenase (LDH) levels is a simple, quick, and widely available laboratory test in most health facilities. Lactate dehydrogenase levels change significantly in patients with tissue damage including COVID-19 disease. The purpose of this study was to analyze the LDH levels as a marker of the severity of COVID-19. The research method used was a cross-sectional approach using primary data from 70 suspected COVID-19 patients from June to July 2021 at Labuang Baji Hospital, Hasanuddin University Hospital, and Makassar City Hospital. Samples were grouped into mild, moderate, and severe COVID-19. The LDH levels at the time of hospital admission were measured using an Architect device. Chi-Square, Kruskal-Wallis, and ROC curve statistical tests were used to obtain the LDH value with a significant value of p250.5 U/L, NPV of 96.4%, PPV of 87.5%, and accuracy of 91.3%. LDH levels increase along with the increasing severity of COVID-19 caused by tissue damage due to increased inflammatory response. LDH can be used as a marker of COVID-19 severity.

Sepsis is one of the main causes of mortality in the intensive care unit. The SOFA score is used to assess organ dysfunction. There are several markers of sepsis such as the combination of RDW, PDW, and NLR to help predict the outcome of sepsis. To determine the role of RDW, PDW, and NLR associated with SOFA scores as prognostic markers in sepsis. A retrospective study with a cross-sectional approach has been conducted using secondary data from the medical records of sepsis patients from January 2018 to December 31, 2020, who met the inclusion criteria and were admitted to the ICU of Dr. Wahidin Sudirohusodo Hospital, Makassar. The sample size was 109 people consisting of 62 (56.9%) males and 47 (43.1%) females. The highest age range is 56–65 years (37.6%). A total of 97 people (89%) died and 12 (11%) improved. There is a positive correlation between changes in RDW and changes in SOFA scores (p=0.031), there is a positive correlation between changes in PDW and changes in SOFA scores (p=0.000), and there is a positive correlation between changes in NLR and changes in SOFA scores (p=0.000). The increase of RDW caused by systemic inflammation can predict disease progression. The state of increased proinflammatory cytokines inhibits the proliferation and maturation of erythrocytes; hence, it causes an increase in RDW. The acceleration of platelet destruction due to the suppression of cytokines in the bone marrow increases PDW. The increase in NLR occurs due to the rise in the inflammatory response, which results in suppressed cellular immunity. RDW, PDW, and NLR are positively correlated with changes in SOFA scores. PDW and NLR have a significant correlation with the outcome. RDW, PDW, and NLR can be used as prognostic markers in septic patients

The limitations of health facilities in diagnosing AMI, especially in remote areas require an easy and inexpensive examination such as Neutrophil Lymphocyte Ratio (NLR) and High-Density Lipoprotein (HDL), which have a positive correlation with hs-Troponin I. The purpose of this study was to analyze the value of NLR, HDL, and hs-Troponin I as diagnostic markers in STEMI and NSTEMI patients. This retrospective study used medical record data for 152 STEMI patients and 93 NSTEMI patients from January to December 2020 at Dr. Wahidin Sudirohusodo. The NLR value was based on the results of routine blood tests using Sysmex XN-10, the results of HDL examinations using the Bio Majesty JCA-BM9010/c instrument, and the results of the hs-Troponin I examination using the Vidas instrument. Statistical tests using the MannWhitney test, the diagnostic value of NLR, and hs-Troponin I was analyzed by ROC to obtain the cut-off. The test result is significant if p

The Neutrophil-Lymphocyte Ratio (NLR) and procalcitonin are used to indicate systemic inflammation in variousmedical disorders. Both parameters were determined in this study to predict the severity of acute pancreatitis. This studywas a cross-sectional study using a retrospective approach to patients diagnosed with acute pancreatitis by using medicalrecord data from patients at Dr. Wahidin Sudirohusoso Hospital, Makassar, from January 2014 to May 2019. This studycomprised 35 patients hospitalized with acute pancreatitis, with a similar proportion of males and females. This studydiscovered that the mean age in this study was 44.17±12.9 years. The most prevalent cause was Gallstones (77.1%), themost severe degree was mild (54.2%), and the highest outcome was survival (77.1%). The NLR (9.93±11.19, p=0.011)increased in proportion to severity. However, additional analysis based on classification of disease severity revealed thatonly mild-severe NLR was significant (p=0.005). Procalcitonin (8.13±11.25, p=0.001) increased along with the increaseddisease severity, and the subsequent analysis showed that the distribution of severity was similar. The NLR can predict theseverity of acute pancreatitis but is less effective than procalcitonin. This study required a more proportional subjectpopulation and consideration of other factors.

Hereditary Hemochromatosis (HH) is an autosomal recessive genetic disease characterized by abnormalities in iron regulation, mostly due to mutations in the HFE gene, leading to increased iron absorption due to hepcidin deficiency. The classification of HH is based on the type of mutated gene, which must be distinguished from non-genetic conditions that cause secondary elevations in serum iron levels such as multiple transfusions and increased iron supplementation. Pathophysiological mechanisms of HH include increased absorption of iron in the upper intestine, decreased expression of the iron regulatory hormone hepcidin, altered function of the HFE protein, and tissue damage and fibrogenesis caused by iron overload. The human body is physiologically unable to excrete excess iron load so excess iron in serum will be deposited in various organs, causing organ dysfunction. The clinical manifestations of hemochromatosis vary widely depending on the location of iron deposition in the organ. The classic clinical triad of hemochromatosis is liver cirrhosis, skin pigmentation, and diabetes mellitus. Hemochromatosis can be screened for and diagnosed by examining serum ferritin levels, transferrin saturation, unsaturated iron-binding capacity, total iron-binding capacity, liver biopsy, magnetic resonance imaging, and genetic testing. The main treatment for hemochromatosis at this time is phlebotomy although other therapeutic methods can also be used to help lower iron levels and improve the patient's clinical course, such as therapy with chelating agents, erythrocytopharesis, and liver transplantation. If hemochromatosis is not treated, the patient can experience progressive liver damage leading to cirrhosis and hepatocellular carcinoma, and complications due to damage to various tissues and organs. &nbsp

Acute appendicitis is inflammation of the vermiformis appendix due to lumen obstruction followed by bacterial infection. Acute appendicitis is classified into two types of disease, namely complicated and uncomplicated. Acute inflammation of the appendix requires immediate surgical action to prevent complications; therefore, a further laboratory test is required. This study was retrospective research which analyzed several hematologic parameters (WBC, Neutrophils, NLR, RDW, PLTMPV, PDW) and serum bilirubin levels. Data were statistically analyzed using Independent-t and Mann-Whitney test. Univariate logistic regression test was used to evaluate the correlation of hematologic parameters and significant serum bilirubin levels with the diagnosis of complicated and uncomplicated appendicitis. The cut-off value and diagnosis value were measured using Receiver Operating Characteristic (ROC) curve analysis. This study involved 173 subjects categorized into 67 complicated and 106 uncomplicated acute appendicitis patients. Whole blood count and neutrophil counts were significantly higher in complicated acute appendicitis (p 0.05 was obtained in RDW-CV, MPV and PDW values. The higher serum bilirubin levels were reported in patients with complicated acute appendicitis compared to uncomplicated acute appendicitis (p

It is reported the incidence of DVT is approximately 84 cases per 100,000 each year, with 30-50% of untreated DVT are atrisk for pulmonary embolism, causing a 12% increase in mortality rate. An accurate and rapid diagnosis of DVT is needed tominimize the risk of complications and prevent unnecessary anticoagulant therapy without waiting for the results of adiagnostic examination using ultrasound. This study aimed to determine the diagnostic value of plasma D-dimer levels onDoppler ultrasound for DVT diagnosis to help clinicians to select a rapid and accurate diagnostic test for DVT diagnosis. Thisresearch was a retrospective study using data from medical records and performed at the Medical Record Installation of Dr.Wahidin Sudirohusodo Hospital, Makassar, by taking data on patients with DVT along with the results of D-dimer andDoppler ultrasound from January to December 2018. D-dimer levels were measured using an immunoturbidimetric methodwith a reference value of 0.05). Also, the mean of Wellsscore was higher in positive Doppler (4.74) compared to negative (4.17), although not statistically significant (p> 0.05). Thediagnostic values of D-dimer were as follows: sensitivity of 92.6%, specificity of 33.3%, positive predictive value of 86.2%,negative predictive value of 50.0%, and accuracy of 81.8%. D-dimer test can be used both for screening and diagnostic testswith cut-off value ≥ 2 μg/mL.

Hematology abnormalities are commonly found in Hepatocellular Carcinoma (HCC) patients. Platelet (PLT) count in HCC can be low, normal or high, and influenced by tumor and liver damage. There are limited studies about the correlationp between AFP and platelet profile of HCC in Indonesia, especially in Makassar. This study is aimed to analyze the correlation between AFP and platelet profile in HCC patients. A retrospective cross-sectional study was carried out from January 2016 to June 2017 on 231 HCC subjects. The correlation between AFP and platelet profile, the correlation of AFP and platelet profile with the diagnosis were analyzed by Independent t-test and Chi-Square. There was no significant correlation between AFP and PLT profile and no significant correlation between AFP and HCC with and without cirrhosis with p>0.05 and p=0.094, respectively. Platelet count and PCT were significantly lower in cirrhotic HCC ompared to non-cirrhotic HCC (p

Stroke is a functional disorder attributed to acute focal or global brain injury by vascular cause and persists more than 24 hours. Stroke is divided into ischemic and hemorrhagic strokes. Red Blood Cell Distribution Width (RDW) is a measurement of erythrocyte volume variation in blood circulation. Increased RDW reflects the inflammation that plays a role in the development of atherosclerosis in stroke. This study aims to analyze differences in RDW-CV values in patients with stroke. The design was cross-sectional with a retrospective approach, secondary data from medical records of inpatients with stroke from January to December 2016 at the Dr. Wahidin Sudirohusodo Hospital. The study population consisted of 490 patients aged ≥ 18 years old. The Kruskal-Wallis, Mann-Whitney, and Anova one way tests were used to analyze differences in RDW-CV values in patients with ischemic and hemorrhagic stroke. Mann-Whitney test results showed no significant difference in RDW-CV values between groups of ischemic and hemorrhagic stroke (p 0.96). Kruskal-Wallis and Anova one way tests showed no significant difference in RDW-CV values between four groups of patient outcomes in ischemic and hemorrhagic stroke (p 0.13 and p 0.35 consecutively). There were no significant RDW-CV values between ischemic and hemorrhagic stroke. There was no significant difference between RDW-CV values of four groups of patient outcomes in ischemic and hemorrhagic stroke. RDW-CV values cannot be used to distinguish both ischemic and hemorrhagic stroke, including the prediction of stroke mortality

Introduction: Acute Leukemia with Mixed Lineage phenotype (MLL) is leukemia that consists of cells characterized by mixed lineage markers, both from myeloid and lymphoid cells. The incidence of this leukemia is only 2-5% of all acute leukemias and is considered to have a poor prognosis.Case Presentation: A seven-year-old girl was diagnosed with MLL. The results of immunophenotyping showed two blast populations with the expressions of CD33, CD34, HLA-DR, CD117, CD13, CD19, CD10, CD20, CyMPO, Cy CD79a, and morphological features of Acute Lymphoblastic Leukemia (ALL) and Acute nonLymphocytic Leukemia (AnLL) on bone marrow aspiration. The BCR-ABL examination showed the detected BCR-ABL p210 (Major breakpoint), the majority of which was found in chronic myeloid leukemia (CML) patients. There is no definite pathogenesis of BCR-ABL p210 (MBCR-ABL) in this patient. BCR-ABL can also present in 11–29% of ALL patients but is relatively rare in childhood ALL (1%–3%) and mostly expresses p190 (minor breakpoint (mBCR-ABL)). The p210 BCR-ABL transcript is detected in 30% of adults and 20% of childhood ALL patients with Philadelphia ALL. Conclusions: MLL with BCR-ABL p210 transcript is very rare in acute leukemia. Immunophenotyping tests can detect typical MLL profiles, and WHO has standardized the diagnosis for MLL.

Chronic Myeloid Leukemia (CML) is one of leukemias characterized by abnormal growth of myeloid cells in bone marrow. The Philadelphia chromosome is diagnostic parameter for CML. This chromosome is t(9;22) (q32;q21), a translocation chromosome 9 and 22 relocates a portion of proto-oncogene c-ABL from chromosome 9 to BCR on chromosome 22. Chronic myeloid leukemia consisting of three phases; Chronic, Accelerating and the Blast crisis phase. The clinicaling symptoms of CML are hypercatabolism, splenomegaly, anemia, bruising and sign of Gout. Chronic myeloid leukemia in pregnancy shows a better prognosis than acute leukemia in pregnancy. Chronic myeloid leukemia has the risk of leukocytosis which can lead to uteroplacental insufficiency giving rise to various consequences: fetal growth retardation and perinatal mortality. Moreover, the therapy of CML should be carefully administered considering the fetal effects. Both sexes have the same risk, mostly in the range of 40 to 60 years old. In this case report, a 38-year-old pregnant female (G1P0A0) with 37 weeks of gestational age was diagnosed as CML on August 2013 and was treated with 500 mg of Cytodrox/Hydroxyurea twice to three times a day until January 2014. Laboratory evaluation on November 10th, 2014, showed leucocytes 449500/µL, erythrocytes 2.58.106/µL, hemoglobin 8.0 g/dL, thrombocytes 437,000/µL and hematocrit 23%. The peripheral blood smear showed normocytic normochromic erythrocytes, anisocytosis, ovalocytes, significantly increased leucocyte count, predominance polymorphonuclear series, all maturation series of myelocytes, 7% myeloblast, normal thrombocyte count and morphology. Based on these evaluations, the patient was diagnosed as CML. The evaluation of Neutrophil Alkaline Phosphatase (NAP) scored 1.

Thalassemia is a quantitative abnormality of the hemoglobin marked by inadequate hemoglobin synthesis due to the lack orabsence of synthesis of one or more globin polypeptide chains. Hemoglobin variant is a qualitative abnormality due to the presence ofthe abnormal amino acid sequence of one or more globin polypeptide chains. HbE β thalassemia is a disorder of hemoglobin that resultsfrom the fusion between the gene β-thalassemia allele from one parent with a gene HbE allele from another parent. In this case, HbEβ-Thalassemia patient was a 4.8 year girl diagnosed with hemoglobin E-beta thalassemia based on history and clinical manifestations;pale, the presence of splenomegaly and hepatomegaly. Laboratory tests were Hb: 7.7 g/dL, MCV: 52.9 fl, MCH: 17.7 pg, MCHC: 33.5g/dL and ferritin: 1012 ng/mL. Peripheral blood smear evaluation showed a microcytic hypochromic anemia with hemolytic signs andinfected features of leukocytes. Hb electrophoresis using HPLC showed a Hb F: 37.7% and HbA2 52.4%, indicating that HbA2 was falsehigh due to coeluating with HbE. The patient was treated by blood transfusion and received additional therapy such as folic acid, ironchelation and vitamin E.

Mieloma Multipel (MM) merupakan penyakit tertentu di individu yang berusia lanjut. Kejadian mieloma multipel di pasien berusia dibawah empat puluh tahun adalah sangat jarang. Mieloma multipel merupakan kasus keganasan sel plasma yang mengenai banyak tulangdengan gejala peningkatan protein monoklon di serum/air kemih atau keduanya. Hal ini harus dibedakan dengan kasus peningkatanprotein monoklon yang lain seperti plasmasitoma soliter yang hanya terjadi di satu tulang. Dalam kasus ini dipaparkan pasien mielomamultipel laki-laki dewasa muda berumur 34 tahun, dengan hasil memeriksa laboratorik dan radiologis yang mendukung diagnosismieloma multipel tertentu. Keluhan utama berupa nyeri punggung yang disertai dengan kondisi tulang yang rapuh di gambaranradiologik. Pasien dirawat di rumah sakit selama tujuh belas hari di ruang perawatan bagian Bedah Ortopedi Rumah Sakit WahidinSudirohusodo, Makassar. Pasien meninggal pada hari ke-17 sesaat setelah menjalani kemoterapi pertama. Gambaran laboratorik yangmenonjol dan khas selama perawatan di rumah sakit seperti pemeriksaan hapusan aspirasi sumsum tulang, pemeriksaan elektroforesisserum protein, hematologik rutin, laju endap darah, zat kimia klinik (seperti kalsium, asam urat, uji fungsi hati, ureum dan kreatinin)dan pemeriksaan radiologik berupa foto polos tulang. Dalam makalah ini akan dipaparkan secara jelas, sampai akhirnya penyakit inididiagnosis beserta derajat dan perjalanan penyakitnya. Penanganan dan pengobatan pasien mieloma multipel selama perawatan inapdi rumah sakit juga akan dipaparkan dengan jelas dalam makalah ini.

Hairy cell leukaemia (HCL) is a neoplastic disorder of B lymphocytes originally described by Bouroncle et al. in 1958. HCL clinicalmanifestations varies, generally characterized by various degrees of splenomegaly, pancytopenia, or emphasis only on the two cell lines(bisitopenia), with the hairy cells in varying amounts in the peripheral blood smear and bone marrow. HCL is a very rare case, there areonly about 2% of all leukaemias more frequently in men than women (4:1) with the average age of disease onset between 50–55 years.The etiology of HCL is still not known. A case of HCL Leukaemia in a female patient, aged 55 years is reported which was a rare case.HCL diagnosis in this patient was based on the clinical manifestation (splenomegaly), and laboratory results (bisitopenia, neutropeniaand monositopenia) and about 80% hairy cells were found in peripheral blood smears. Definite diagnosis of HCL should be made by bonemarrow examination, immunophenotyping and cytogenesis.

Prothrombin Time (PT) and an activated Partial Thromboplastin Time (aPTT) are routine coagulation tests used for pre-operative screening. The analytical step as one of the laboratory test's stage that plays the role in the determination of the test is influenced by several factors, one of them is choosing its proper devices. The aim of this study was to know the correlation of the PT and aPTT test's result using Humaclot VA and Sysmex CA 500 devices. A cross sectional study has been done at the Clinical Pathology Laboratory of Wahidin Sudirohusodo Hospital Makassar started from May 2009 until June 2009. The data were analyzed with T and Pearson's Correlation test. From the 50 samples were obtained the percentage of the corresponding frequency of the PT results between Humaclot VA and Sysmex CA 500 about 84%, whereas the frequency of the corresponding results aPPT between Humaclot VA and Sysmex CA 500 is 76%, the Pearson correlation test for PT=0.58, and aPTT=0.38. There were found the suitability of PT, aPTT of Humaclot VA with CA 500 and both tools have a positive correlation.