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"Transfusi darah berulang pada subjek thalassemia mayor berpotensi menyebabkan transmisi virus hepatitis B dan / atau C. Infeksi dapat menyebabkan perubahan kadar feritin serum. Penelitian ini bertujuan untuk mengetahui prevalensi infeksi varian virus hepatitis dan hubungannya dengan kadar feritin serum. Penelitian potong-lintang dilakukan dengan membandingkan kadar feritin serum antar kelompok subjek terinfeksi varian virus hepatitis pada subjek thalassemia mayor di RS Cipto Mangunkusumo Kiara Jakarta antara tahun 2006-2015. Hasil penelitian menyebutkan bahwa prevalensi infeksi hepatitis keseluruhan sebesar 10,06 subjek dan didapatkan nilai p < 0,050 dari uji komparasi antara kadar feritin serum pada kelompok subjek hepatitis B dengan hepatitis C, hepatitis B dengan hepatitis B dan C, hepatitis C dengan non-hepatitis serta hepatitis B dan C dengan non-hepatitis. Pevalensi infeksi hepatitis keseluruhan pada penelitian ini lebih rendah dibandingkan dengan penelitian lain dan terdapat hubungan yang bermakna antara kadar feritin serum pada kelompok subjek hepatitis B dengan hepatitis C, hepatitis B dengan hepatitis B dan C, hepatitis C dengan non-hepatitis serta hepatitis B dan C dengan non-hepatitis.

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Regular blood transfusion in major thalassemia subjects potentially mediates infection of hepatitis B and or C virus. Infection can change serum ferritin level. This research intends to know the prevalence of hepatitis virus variant infection and its association with serum ferritin level. This research used cross sectional method to compare serum ferritin level within each hepatitis virus variant infection subject's groups on major thalassemia subjects in RS Cipto Mangunkusumo Kiara Jakarta within 2006 2015. Results showed that prevalence of hepatitis in total was 10.06 subjects and p value from comparison test of serum ferritin level in subject's group of hepatitis B with hepatitis C, hepatitis B with hepatitis B and C, hepatitis C with non hepatitis, and hepatitis B and C with non hepatitis is p 0,050. Prevalence of hepatitis in total was lower than prevalence value in the other studies and there were significant association of serum ferritin level in subject's group of hepatitis B with hepatitis C, hepatitis B with hepatitis B and C, hepatitis C with non hepatitis, and hepatitis B and C with non hepatitis."

"Latar belakang. Kelebihan zat besi akibat transfusi rutin pada penderita thalassemia mayor menyebabkan timbunan zat besi yang akan membuat kerusakan signifikan pada banyak organ, seperti hati dan kelenjar paratiroid, sehingga dapat mengganggu metabolisme vitamin D dan kalsium.Tujuan. Mengetahui hubungan antara kadar feritin serum dengan kadar 25 (OH)D dan kalsium ion pada anak thalassemia mayor.Metode. Penelitian ini adalah studi potong lintang yang dilakukan pada 64 anak thalassemia mayor usia 7-12 tahun dari bulan November hingga Desember 2020 di RS Dr. Cipto Mangunkusumo (RSCM). Feritin serum dan kalsium ion diperiksa di laboratorium patologi klinik RSCM. Pemeriksaan kadar vitamin D 25 (OH)D dengan metode Enzyme-Linked Fluorescent Assay (ELFA) dilakukan di Laboratorium Kalgen Innolab Jakarta.Hasil. Dari 64 subjek, rerata feritin serum (SB) 5537.85 (2976.17) ng/mL, rerata serum vitamin D 25 (OH)D (SB) 15,556 (5,825) ng/mL dan rerata kalsium ion (SB) 1,144 (0,079) nmol/L. Sebanyak 6,3% subjek mengalami hipokalsemia. Defisiensi vitamin D ditemukan pada 34,4% subyek dan insufisiensi pada 45,3% subyek. Koefisien korelasi Pearson antara feritin serum dan vitamin D (r = -0,020, p = 0,873), dan untuk kalsium ion (r = 0,01, p = 0,938).Kesimpulan. Hubungan antara feritin serum terhadap vitamin D dan kalsium ion tidak menunjukkan korelasi. Tingginya prevalens defisiensi vitamin D pada anak thalassemia mayor membutuhkan penanganan lebih komprehensif untuk meningkatkan kesehatan tulang, mencegah patah tulang dan potensi komplikasi terkait lainnya......Background. Iron overload due to routine transfusions in thalassemia major children causes iron deposits that will make significant damage to many organs, such as the liver and parathyroid glands, so that can disrupting the vitamin D and calcium metabolism.Objective. To determine the correlation between serum ferritin levels with 25(OH)D levels and ionized calcium in thalassemia major children.Methods. This study was a cross sectional study was conducted on 64 children with thalassemia major, aged 7-12 years, from November to December 2020 at Dr. Cipto Mangunkusumo (CMH). Serum ferritin and ionized calcium patients were examined in the laboratory of Dr. Cipto Mangunkusumo. Serum 25 (OH)D examination using the Enzyme-Linked Fluorescent Assay (ELFA) method was carried out at the Kalgen Innolab Jakarta Laboratory.Results. From 64 subjects, mean serum ferritin (SD) 5537.85 (2976.17) ng/mL, mean serum vitamin D 25 (OH)D (SD) 15.556 (5.825) ng/mL and mean ionized calcium (SD) 1.144 (0.079) nmol/L. A total of 6.3% of subjects experienced hypocalcemia. Vitamin D deficiency was present in 34.4% of subjects and insufficiency in 45.3% of subjects. Pearson’s correlation coefficient between serum ferritin and vitamin D (r = -0.020, p = 0.873), and for ionized calcium (r = 0.01, p = 0.938).Conclusions. The association between serum ferritin and vitamin D and calcium ions showed no correlation. The high prevalence of 25 (OH)D deficiency in thalassemia major children requires further management to improve bone health, prevent fracture and other related potential complications."

"[ABSTRAKLatar Belakang: Infeksi merupakan penyebab kematian yang penting pada thalassemia. Peningkatan risiko infeksi disebabkan oleh banyak faktor antara lain karena kelebihan besi dan splenektomi. Penelitian ini bertujuan mengetahui perbedaan fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi serta mengetahui hubungan fungsi fagositosis monosit dengan kadar feritin serum.Metode: Penelitian dilakukan di Departemen Patologi Klinik RSCM, Jakarta pada September 2013 ? Februari 2014. Desain penelitian potong lintang, dengan subjek penelitian pasien thalassemia mayor, terdiri dari 58 subjek pasca splenektomi dan 58 subjek non splenektomi yang telah dilakukan macthing umur dan jenis kelamin. Dilakukan pemeriksaan fagositosis monosit menggunakan E.coli yang telah diopsonisasi dan dilabel FITC sebagai target, (PhagotestTM) dan diperiksa dengan flow cytometry BD FACSCalibur. Kadar feritin serum diperiksa dengan Cobas e 601.Hasil: Median fagositosis monosit pada 58 subjek pasca splenektomi 5,03 (0,17 ? 22,79) %, dan pada 58 subjek non splenektomi 7,09 (0,11 ? 27,24) %, dan nilai p > 0.05. Kadar feritin serum pada subjek pasca splenektomi 6.724 (644,60 ? 21.835) ng/mL dan subjek non splenektomi 4.702,50 (1.381 ? 14.554) ng/mL, dan nilai p < 0.05. Hasil uji korelasi fungsi fagositosis monosit dengan kadar feritin didapatkan r = 0.13 (nilai p = 1.00).Kesimpulan: Tidak terdapat perbedaan bermakna antara fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi. Kadar feritin serum pada pasien thalassemia mayor pasca splenektomi lebih tinggi secara bermakna dibandingkan non splenektomi. Tidak didapatkan hubungan antara fagositosis monosit dengan kadar feritin serum.

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ABSTRACTBackground : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level.Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 ? Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601.Result : Median phagocytosis of monocyte was 5,03 (0,17 ? 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 ? 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 ? 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00).Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level.;Background : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level.Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 – Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601.Result : Median phagocytosis of monocyte was 5,03 (0,17 – 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 – 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 – 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00).Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level., Background : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level.Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 – Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601.Result : Median phagocytosis of monocyte was 5,03 (0,17 – 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 – 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 – 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00).Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level.]"

"Latar belakang. Kadar hemoglobin pre-transfusi dan feritin serum mempengaruhi pertumbuhan anak dengan thalassemia B-mayor. Penelitian tentang thalassemia sudah dilakukan di Indonesia, namun penelitian tentang hubungan thalassemia dengan pertumbuhan fisik masih terbatas. Tujuan. Mengetahui pengaruh kadar Hb pre-transfusi dan feritin serum berpengaruh terhadap pertumbuhan fisik pasien thalassemia ?-mayor. Metode. Dilakukan bulan Agustus-Oktober 2017 pada pasien anak dengan thalassemia B-mayor yang berobat ke Thalassemia-Centre RSUD Pekanbaru. Penelitian berupa analitik observasional potong lintang, menganalisis pengaruh kadar Hb pre-transfusi dan feritin serum terhadap parameter perawakan pendek dan sangat pendek, gizi kurang dan buruk, usia tulang yang terlambat. Hasil. Subjek 41 orang, rentang usia 18-204 bulan. Jenis kelamin laki-laki lebih banyak daripada perempuan 53,7 vs 46,3. 40 subjek mengalami retardasi pertumbuhan. Terdapat korelasi bermakna antara kadar Hb pre-transfusi dengan Z-score TB/U r=0,507, p=0,001 dan LILA/U r=0,467, p=0,02. Hb pre-transfusi berpengaruh terhadap interpretasi duduk/umur p=0,007, IK95 -1,5 - -0,3, subischial leg length/umur p=0,002, namun tidak pada interpretasi rasio segmen atas/bawah dan usia tulang. Hasil berbeda pada kadar feritin yang tidak memiliki korelasi terhadap semua variabel. Simpulan. Terdapat pengaruh yang bermakna secara statistik antara kadar Hb pre-transfusi dengan parameter penelitian serta tidak terdapat pengaruh yang bermakna secara statistik antara kadar feritin serum dengan parameter tersebut.

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Background. The level of pre transfusion hemoglobin and ferritin serum affect physical growth on patient with thalassemic mayor. Study about thalassemia is mainly reported but its relationship with physical growth is limited.

Objective. The main objective of the present study was to evaluate the relationship of pre transfusion Hb and serum ferritin level in patient with thalassemic mayor.

Material and method. In this analytical cross sectional study, the growth parameters weight, standing height, sitting height, subischial leg length, nutritional status, bone age were measured in 41 patients attending Thalassemia Centre at RSUD in Pekanbaru from August October 2017.

Results. 41 patients with mean age 18 204 months. The results are boys dominated girls in sex criteria 53,7 vs 46,3. As much as 40 subjects have growth retardation. There rsquo s correlation in pre transfusion hemoglobin with Z score height for age r 0,507, p 0,001 and subischial length r 0,467, p 0,02. This study shows relationship in pre transfusion hemoglobin with sitting height p 0,007, IK95 1,5 0,3, subischial leg length p 0,002, but not in segment length and bone age. Serum ferritin level has no correlation to one of those parameters.

Conclusion. There is a significant relationship in physical growth based on parameters mentioned above with pre transfusion Hemoglobin, but not with serum ferritin level. "

"Latar belakang. Penelitian ini bertujuan menilai gambaran struktur dan fungsi retina serta menilai hubungan antara durasi terapi kelasi besi dan kadar feritin serum dengan abnormalitas struktur retina pada penyandang thalasemia-β mayor yang memperoleh terapi kelasi besi di RSCM. Metode. Penelitian potong lintang ini dilakukan pada penyandang thalasemia-β mayor berusia di atas 10 tahun yang memperoleh terapi kelasi besi dan menjalani kontrol di Pusat Thalasemia RSCM. Subjek dilakukan pemeriksaan oftalmologis, foto fundus, dan fundus autofluorescence. Selanjutnya dilakukan pengambilan subsampel dari subjek awal berdasarkan hasil fundus autofluorescence dan dilakukan pemeriksaan elektroretinografi multifokal dan elektrookulografi. Hasil. Abnormalitas struktur retina didapatkan pada 46,2% subjek sedangkan abnormalitas pemeriksaan fundus autofluorescence didapatkan pada 41,9% subjek. Sebagian besar subjek memiliki tajam penglihatan dan sensitivitas kontras yang normal. Nilai tengah seluruh parameter elektroretinografi multifokal dan rasio amplitudo light peak terhadap dark trough elektrookulografi kedua kelompok subjek berada dalam rentang normal. Didapatkan penurunan sensitivitas kontras yang signifikan pada subjek dengan abnormalitas struktur retina dan makula, namun tidak untuk tajam penglihatan. Kadar feritin serum yang lebih tinggi berhubungan dengan abnormalitas struktur retina. Kesimpulan. Rerata kadar feritin serum dalam periode satu tahun dengan titik potong ≥6.000 ng/ml dapat digunakan sebagai panduan untuk memulai pemeriksaan struktur dan fungsi retina.

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Introduction. This study aims to evaluate retinal structure and function and association between iron chelation treatment duration and serum ferritin level with retinal structure abnormality in β-thalassemia major patients treated with iron-chelating agent in Cipto Mangunkusumo Hospital. Methods. This cross-sectional study was performed on β-thalassemia major patients aged more than 10 years old in Thalassemia Center, Cipto Mangunkusumo Hospital, who received iron-chelating agent for at least one year. Patients underwent ophthalmologic examination, fundus photography, and fundus autofluorescence imaging. Afterwards subsample was chosen based on fundus autofluorescence imaging result, and underwent multifocal electroretinography and electrooculography examination. Results. Retinal structure abnormality was found in 46.2% patients and fundus autofluorescence abnormality in 41.9% patients. The majority of patients had normal visual acuity and contrast sensitivity. Each multifocal electroretinography parameters and light peak to dark trough amplitude ratio in electrooculography had normal median values. Significant contrast sensitivity reduction was found on patients with retinal and macular structure abnormality, but not for visual acuity. Significant association between higher ferritin serum level and retinal structure abnormality was found. Conclusion. Mean ferritin serum level within one year with cutoff point of ≥6.000 ng/ml can be used as a guide to start retinal structure and function evaluation."

"Latar Belakang: Talasemia merupakan penyakit kelainan hemoglobin (Hb) dengan prevalensi tinggi di Indonesia maupun dunia. Komplikasi pada talasemia dapat terjadi akibat kadar Hb pre-transfusi yang rendah dan penumpukan feritin serum. Pengetahuan, sikap, dan perilaku yang baik terhadap suatu penyakit dibutuhkan untuk mencapai kesehatan yang diinginkan dan mencegah komplikasi. Studi ini bertujuan untuk mencari hubungan antara pengetahuan, sikap, dan perilaku terhadap talasemia, Hb pre-transfusi dan kadar feritin serum pada pasien remaja talasemia karena mereka memiliki prevalensi tertinggi. Metode: Kuesioner pengetahuan, sikap, dan perilaku (PSP) melalui google form disebarkan untuk mendapatkan data dari pasien talasemia remaja yang memenuhi kriteria studi. Pengetahuan akan dibagi menjadi adekuat atau tidak adekuat, sikap dibagi menjadi positif atau negatif, perilaku dibagi menjadi baik atau buruk berdasarkan hasil skor kuesioner. Kadar Hb pre-transfusi dan feritin serum diambil dari rekam medik pasien, dan dikelompokkan menjadi Hb dan serum ferritin yang tinggi atau rendah. Hasil Penelitian: Dari 85 subjek, terdapat 49.4% pasien dengan pengetahuan adekuat, 91.8% pasien dengan sikap positif, dan 72.9% pasien dengan perilaku baik. Pasien masih kurang memahami fasilitas skrining dan pentingnya suplementasi vitamin. Pasien perlu meningkatkan sikap positif terhadap skrining thalassemia dan perilaku baik terhadap kepatuhan obat. Terdapat hubungan yang tidak bermakna secara statisik antara pengetahuan, sikap dan perilaku terhadap kadar Hb pre-transfusi dan kadar ferritin (p >0.05) pada remaja dengan talasemia. Kesimpulan: Remaja talasemia di Rumah Sakit Cipto Mangunkusumo memiliki pengetahuan yang tidak adekuat, namun dengan sikap dan perilaku yang baik. Perlu adanya edukasi berkala untuk meningkatkan pengetahuan.

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Introduction: Thalassemia is a hemoglobin (Hb) disorder that has a high prevalence in Indonesia and the world. Complications in thalassemia can occur due to low pre-transfusion Hb and accumulation of serum ferritin. A good knowledge, attitude, and practice towards a disease are needed to achieve desired health outcomes and prevent complications. This study aims to find the relationship between knowledge, attitude, and practice towards thalassemia, pre-transfusion Hb, and serum ferritin levels in thalassemic adolescents as they have the highest prevalence. Methods: Knowledge, attitude, and practice (KAP) questionnaire through google form were distributed to adolescent thalassemic patients who met the criteria. Knowledge will be divided into adequate or inadequate; attitudes are divided into positive or negative; practice is divided into good or bad based on the questionnaire results. Level of Pre-transfusion Hb and serum ferritin were taken from the patient's medical record and grouped into high or low Hb and ferritin. Result: Out of 85 subjects, there were 49.4% patients with adequate knowledge, 91.8% patients with positive attitude, and 72.9% patients with good practice. Patients still lack understanding of screening facilities and the importance of vitamin supplementation. Patients need to increase positive attitude towards thalassemia screening and good behavior towards treatment adherence. There was a statistically insignificant relationship between knowledge, attitude, and practice on thalassemia with pre-transfusion Hb and serum ferritin (p > 0.05) in thalassemic adolescents. Conclusion: Thalassemic adolescents at Cipto Mangunkusumo Hospital have inadequate knowledge, but with good attitudes and behavior. Periodic education is needed to increase knowledge."

"ABSTRAKLatar belakang: Thalassemia merupakan suatu penyakit gen tunggal yang disebabkan oleh kerusakan pada gen dalam mengontrol produksi protein sehingga sel darah merah akan mudah pecah dan pengikatan oksigen terganggu. Hal ini akan memicu terjadinya anemia dan membutuhkan transfusi darah secara rutin dan seumur hidup. Transfusi darah rutin menyebabkan terjadinya akumulasi besi yang memicu beberapa komplikasi, salah satunya adalah gangguan pada fungsi pankreas. Tujuan: Untuk mengetahui hubungan antara profil besi dengan gangguan fungsi pankreas berupa diabetes mellitus dan gangguan toleransi glukosa pada subjek thalassemia mayor. Metode: Desain potong-lintang pada 79 subjek thalassemia mayor di Pusat Thalassemia RS Cipto Mangunkusumo Jakarta. Hasil: Dua 2,53 subjek mengalami gangguan toleransi glukosa dan 77 97,47 subjek dengan nilai toleransi glukosa normal. Nilai median feritin serum pada kelompok gangguan toleransi glukosa yakni 5595,5 2062,0-9199,0 ng/mL sedangkan yang tidak mengalami gangguan toleransi glukosa yakni 3309,0 487,0-11247,0 ng/mL p= 0,574 . Nilai median saturasi transferin pada subjek gangguan toleransi glukosa yakni 76 52-100 sedangkan yang tidak mengalami gangguan toleransi glukosa yakni 89 11-100 p= 0,827 . Kesimpulan: Tidak didapatkan adanya hubungan yang signifikan antara kadar feritin serum dan saturasi transferin terhadap gangguan fungsi pankreas.

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ABSTRACTBackground Thalassemia is a single gene disease that is caused by defect on gene which controls the protein production that eventually leads to red blood cell lysis and defect on oxygen binding capacity. Therefore, the patient needs regular blood transfusion during his lifetime. Regular blood transfusion causes iron accumulation that leads to complications such as defect on pancreas function. Aim To know the association between iron profile and defect on pancreas function such as diabetes mellitus and glucose intolerance in major thallassemia subjects. Methods Cross sectional design on 79 major thalassemia subjects in Thalassemia Center of RS Cipto Mangunkusumo, Jakarta. Results Two 2.53 subjects were glucose intolerant and 77 97,47 subject has a normal blood glucose. Median value of serum ferritin level in glucose intolerant subjects was 5595.5 2062,0 9199,0 ng mL meanwhile the median value of serum ferritin level in normal glucose level subjects was 3309.0 487,0 11247,0 ng mL p 0.574 . The median value of transferrin saturation in glucose intolerant patients is 76 52 100 meanwhile the median value of tranferrin saturation level in normal glucose level subjects is 89 11 100 p 0,827 . Conclusion There is no significant association between serum ferritin level and transferrin saturation and defect of pancreas function."

"Latar belakang. Gagal jantung dan aritmia merupakan penyebab kematian tersering pada penderita thalassemia R. Gangguan fungsi jantung, khususnya disfungsi diastolik merupakan komplikasi dini pada jantung akibat muatan besi berlebih (iron overload). Kadar feritin serum sampai saat ini masih secara luas digunakan sebagai parameter muatan besi berlebih (iron overload).Tujuan. Mengetahui perbedaan kadar feritin serum antara penderita thalassemia j3 dewasa yang mengalami dan tidak mengalami disfungsi diastolik ventrikel kiri, dan mengetahui besar proporsi disfungsi diastolik pada penderita thalassemia 13 dewasa.Metodologi. Penelitian ini merupakan studi potong lintang untuk melihat perbedaan kadar feritin serum (sebagai parameter iron overload) pada penderita thalassemia 13 dewasa yang mengalami disfungsi diastolik dibandingkan dengan yang tanpa disfungsi diastolik, serta untuk mendapatkan proporsi disfungsi diastolik pada penderita thalassemia 3 dewasa. Analisis terhadap variabel-variabel yang diteliti menggunakan uji-1 independen untuk mendapatkan perbedaan rerata kadar feritin serum antara kedua kelompok.Hasil. Dari penelitian ini 30 orang penderita thalassemia 13 dewasa, laki-laki 13 orang, perempuan 17 orang, didapatkan rerata usia 25,9 tahun dengan rentang usia antara 18-38 tahun. Rerata Hb sebesar (7,5g%, SB I,4g%) dengan rentang kadar Hb antara 5,2 - 9,9 g%. Rerata kadar feritin serum sebesar (5590ng1m1, SB 4614,7 nglml) dengan rentang kadar, feritin antara 296,4 - 15900 nglml. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%.Kesimpulan. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%.

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Background. Heart failure and aritmia is the major cause of death in 3 thalassemia major. Heart dysfunction, especially diastolic dysfunction in ji thalassemia seems to be an early involvement of the heart due to iron overload. Serum ferritin level as a parameter of iron overload still widely use for evaluation in 13 thalassemia.

Objectives. To know the mean difference of serum ferritin level between adult 13 thalassemia patients who have left ventricular diastolic dysfunction and who do not have Ieft ventricular diastolic dysfunction, and to obtain the proportion of diastolic dysfunction in adult 13 thalassemia patients.

Methods. This cross-sectional study was conducted to see the mean difference of Serum ferritin. IeVel'(as a parameter of iron overload) in adult P'thalassemia who have left ventricular diastolic dysfunction and who do not have left ventricular diastolic dysfunction and to know the proportion of diastolic dysfunction among adult 13 thalassemia. The independent t-test was used to analyze the variables to obtain the mean difference of serum ferritin level between the two groups.

Results. Thirty adult P thalassemia patients, 13 were male and 17 were female had been enrolled into this study. The age of the patients ranged from 18 to 38 years old, and the average-age was 25,9 years. The Hb level ranged from 5,2 to 9,9 g% and the mean was (7,5g%, SD 1,4g°/o). The serum ferritin level ranged from 296,4 to 15900 nglml, and the mean was (5590ng/ml, SD 4614,7 nglml). There was no significance mean difference serum ferritin level in patients who had diastolic dysfunction and those who do not have diastolic dysfunction. The proportion of diastolic dysfunction in adult 13 thalassemia patients in this study was 70%.

Conclusions. There was no significannce mean difference serum ferritin level in patients who had. diastolic dysfunction and those. who. did, not have diastolic dysfunction . The proportion of diastolic dysfunction in adult thalassemia 3 patients in this study was 70%."

"Karsinoma hepatoseluler (KHS) adalah salah satu kanker dengan laju mortalitas tertinggi di dunia. Kadar serum alfa-fetoprotein (AFP) dapat digunakan sebagai biomarker untuk menegakkan diagnosis dini. Tetapi, perbandingan antara kadar serum AFP dan KHS dengan etiologi infeksi virus dan etiologi non infeksi virus belum diketahui. Mengetahui perbandingan antara kadar serum AFP dan KHS dengan etiologi infeksi virus dan etiologi non infeksi virus. Penelitian potong lintang dilakukan di RSUPN Cipto Mangunkusumo, Jakarta pada Januari-Oktober 2018 dengan melihat data rekam medis dari 287 pasien yang terdiagnosis KHS dalam periode 2013-2017. Nilai median (minimum-maksimum) dari kadar AFP pada pasien KHS dengan etiologi infeksi VHB atau VHC adalah 419 (0.8-400.000). Nilai median (minimum-maksimum) kadar AFP pada pasien KHS dengan etiologi non infeksi VHB-VHC adalah 7.18 (0.6-90.944). Terdapat perbedaan bermakna antara kadar AFP dengan KHS dengan etiologi infeksi VHB atau VHC dan etiologi non infeksi VHB-VHC.

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Hepatocellular carcinoma (HCC) is one of the highest rates of mortality in the world. Serum alpha-fetoprotein (AFP) levels can be used as a biomarker for early diagnosis. However, the comparison between serum AFP and HCC with viral infections etiology and non-viral etiology is unknown. This research aims to determine the comparison between serum AFP and HCC with viral infections etiology and non-viral aetiology. A cross-sectional study conducted in Cipto Mangunkusumo Hospital, Jakarta in January to October 2018 by reviewing 287 medical records of patients diagnosed with HCC from 2013-2017 period of time. The median (minimum-maximum) value of AFP levels in HCC patients with the etiology of HBV or HCV infection is 419 (0.8-400,000). The median value (minimum-maximum) of AFP levels in HCC patients with the etiology of non HBV-HCV infection was 7.18 (0.6-90,944). There were significant differences between AFP levels and KHS with the etiology of HBV or HCV infections and the etiology of non HBV-HCV infections."

"Penelitian ini bertujuan untuk mengetahui keluhan subjektif mata kering dan gangguan komponen air mata (lipid, akuos, mucin) pada pasien thalassemia mayor dengan riwayat transfusi darah jangka panjang, serta menganalisis hubungan antara kadar feritin serum, durasi, dan frekuensi transfusi darah dengan masing-masing parameter penilaian komponen lapisan air mata. Penelitian ini merupakan studi potong lintang (cross sectional) pada pasien thalassemia mayor yang sudah berusia dan mengalami transfusi darah selama minimal 10 tahun. Penilaian mata kering terdiri dari pengisian kuesioner OSDI untuk menilai keluhan subjektif, pemeriksaan biomikroskopi lampu celah dan nilai tear break up time (TBUT) untuk menilai tingkat keparahan mata kering, pemeriksaan Schirmer basal, Ferning, dan sitologi impressi konjungtiva untuk menghitung jumlah sel goblet. Data perhitungan tingkat keparahan mata kering, nilai uji Schirmer basal, TBUT, dan jumlah sel goblet dianalisis dan dicari hubungannya dengan kadar feritin serum, durasi dan frekuensi transfusi. Pada 77 subyek, mata kering terjadi sebanyak 14.3%, penurunan nilai TBUT (39%), nilai Schirmer basal (37.7%), nilai Ferning (24.7%), dan jumlah sel goblet (45.5%). Tidak terdapat perbedaan bermakna antara tingkat keparahan mata kering, nilai TBUT, nilai Schirmer basal, nilai Ferning, dan jumlah sel goblet dengan kadar feritin serum, durasi, dan frekuensi transfusi. Namun, terdapat hubungan yang bermakna antara tingkat keparahan mata kering dan usia (p = 0.014), serta nilai TBUT (p = 0.012) dan Schirmer (p = 0.014) dengan jenis kelamin. Penelitian ini memperlihatkan 14.3% subyek thalassemia mayor mengalami mata kering berdasarkan kriteria DEWS 2007. Kejadian mata kering pada thalassemia mayor tidak dipengaruhi oleh faktor transfusi dan kadar feritin serum, melainkan dipengaruhi oleh usia dan jenis kelamin.

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This study is aimed to understand subjective complaints for dry eyes and disruption of component of tear fluid (lipid, aqueous, mucin) in patients with major thalassemia with a history of long-term blood transfusions and to analyse the correlation between serum ferritin level, duration and frequency of blood transfusion. This study is a cross-sectional study. The subject of this study is patients with major thalassemia age minimum of 10 years old and have had blood transfusion for at least 10 years. OSDI questionnaire, slit-lamp biomicroscopy examination, tear break up time (TBUT), and basal Schirmer test was used to assess dry eyes severity. Ferning and conjunctiva impression cytology examination was used to assess mucin quality and count the amount of goblet cells. The correlation analysis between the result of these assessments and serum ferritin level and duration and frequency of blood transfusion was done. In 77 subjects, the prevalence of dry eyes is 14.3%. There is a decrease in TBUT (39%), basal Schirmer (37.7%), Ferning (24.7%), and goblet cells (45.5%). There is no significant correlation between dry eyes severity and TBUT, basal Schirmer, Ferning, and the amount of goblet cells with serum ferritin level, duration, and frequency of blood transfusion. There is a significant correlation between dry eyes severity and patient s age (p = 0.014); TBUT (p = 0.012), as well as, Schirmer (p = 0.014) with sex. This study showed that 14.3% of patients with major thalassemia suffer from dry eyes with severity level grade 2 according to DEWS 2007. The incidence of dry eyes is not influenced by transfusion and serum ferritin level but is influenced by age and sex."