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"Aim: to evaluate the correlation and the concordance between reticulocyte hemoglobin equivalent (RET-He) and reticulocyte hemoglobin content (CHr) as well as to obtain the cut-off value of RET-He as the target of iron supplementation in chronic kidney disease (CKD) patients undergoing hemodialysis. Methods: a cross-sectional study was performed using K3EDTA-anticoagulated peripheral blood samples collected from 106 CKD patients undergoing routine hemodialysis. The samples were then analyzed using both Sysmex XN-2000 and Siemens ADVIA 2120i for RET-He and CHr analysis. Results: a very strong correlation (r=0.91; p<0.0001) and a good concordance were found between RET-He and CHr with mean bias of 0.5 pg. The diagnostic concordance was 96.23%. The cut-off value of RET-He 29.2 pg was obtained from the receiver operating characteristic (ROC) curve with CHr as the gold standard. At this cut-off point, the sensitivity and specificity to assess the target of iron supplementation in CKD patients undergoing hemodialysis were 95.5% and 94%, respectively. Conclusion: the study shows a good correlation and concordance between RET-He and CHr in CKD patients undergoing hemodialysis.

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Tujuan: mendapatkan korelasi dan kesesuaian antara nilai reticulocyte hemoglobin equivalent (RET-He) dan reticulocyte hemoglobin content (CHr), serta nilai cut-off RET-He sebagai target terapi suplementasi besi pada pasien dengan penyakit ginjal kronik (PGK) yang menjalani hemodialisis.

Metode: penelitian ini menggunakan desain potong lintang terhadap 106 pasien PGK dengan hemodialisis rutin yang dilakukan pengambilan darah K3EDTA untuk pemeriksaan RET-He dengan Sysmex XN-2000 dan CHr dengan Siemens ADVIA 2120i. Hasil: didapatkan korelasi sangat kuat (r=0,91; p<0,0001) dan kesesuaian yang baik antara nilai RET-He dan CHr dengan perbedaan rerata 0,5 pg. Sebanyak 96,23% data berada dalam batas kesesuaian. Nilai cut-off RET-He 29,2 pg didapatkan dari analisis kurva receiver operating characteristic (ROC) dengan CHr sebagai standar baku emas. Nilai cut-off RET-He 29,2 pg memiliki sensitivitas 95,5% dan spesifisitas 94%.

Kesimpulan: penelitian ini menunjukkan korelasi dan kesesuaian yang baik antara RET-He dan CHr pada pasien PGK dengan hemodialisis"

"Ekuivalen hemoglobin retikulosit menggambarkan banyaknya besi dalam retikulosit yang akan digunakan dalam proses pembentukan hemoglobin. Pada alat Sysmex parameter tersebut dikenal sebagai Ret-He. Namun demikian, saat ini parameter tersebut belum digunakan secara rutin di Indonesia. Tujuan penelitian ini adalah untuk mendapatkan nilai cut off, sensitivitas dan spesifisitas Ret-He untuk penilaian status besi pada pasien penyakit ginjal kronik dengan hemodialisis. Desain penelitian potong lintang, terdiri dari 120 subyek PGK dengan hemodialisis. Dilakukan pemeriksaan hematologi lengkap, Ret-He serta pemeriksaan besi serum dan unsaturated iron binding capacity (UIBC) untuk menghitung nilai saturasi transferin. Penentuan nilai cut off Ret-He berdasarkan kurva receiver operating characteristic (ROC) dengan saturasi transferin sebagai baku emas. Untuk penilaian status besi, didapatkan nilai cut off Ret-He 30,3 pg dengan sensitivitas 81,6% dan spesifisitas 76,8% . Parameter Ret-He dapat digunakan sebagai alternatif untuk penilaian status besi pasien penyakit ginjal kronik dengan hemodialisis.

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Hemoglobin reticulocyte equivalent represent the iron content in the reticulocyte that will be used in hemoglobinization process. In Sysmex hematology analyzer this parameter known as Ret-He. However, this parameter has not been routinely used in Indonesia. The objective of this study is to determine cut-off, sensitivity and specificity of Ret-He to assess iron deficient state in chronic kidney disease patients undergoing hemodialysis. One hundred and twenty patients undergoing hemodialysis were included in the study. Complete blood count, Ret-He and transferin saturation were determined. The receiver operating characteristic curve were demonstrated to obtain the cut off value of Ret-He. In 30.3 pg Ret-He cut off point, the sensitivity and spesificity to assess iron deficient state were 81.6% and 76.8% respectively. Ret-He can be used as an alternative parameter to assess iron deficient state in chronic kidney disease patients undergoing hemodialysis."

"Kesesuaian antara reticulocyte hemoglobin equivalent (RET-He) dan reticulocyte hemoglobin content (CHr) untuk menilai status besi pasien penyakit ginjal kronik dengan hemodialisis (PGK-HD) belum diketahui. Penelitian ini bertujuan mendapat kesesuaian antara RET-He dan CHr, serta nilai cut off RET-He sebagai target terapi besi pasien PGK-HD. Desain penelitian potong lintang. Subyek 106 pasien PGK-HD yang diperiksa RET-He menggunakan Sysmex XN-2000 dan CHr dengan Siemens ADVIA 2120i. Didapatkan korelasi sangat kuat (r=0,91; p<0,0001) dan kesesuaian yang baik antara RET-He dan CHr (perbedaan rerata 0,5 pg). Nilai cut off RET-He 29,2 pg sebagai target terapi besi pasien PGK-HD memiliki sensitivitas 95,5%, spesifisitas 94%.

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The concordance between reticulocyte hemoglobin equivalent (RET-He) and reticulocyte hemoglobin content (CHr) to assess iron status in chronic kidney disease patients undergoing hemodialysis (CKD-HD) was unknown. The aim of this study was to evaluate the concordance between RET-He and CHr, and to obtain the cut off value of RET-He as iron supplementation target in CKD-HD patients.

A cross sectional study from 106 CKD-HD patients were analysed on both Sysmex XN-2000 and Siemens ADVIA 2120i. There was very strong correlation (r=0.91; p<0.0001) and good concordance between RET-He and CHr (mean bias 0.5 pg). The cut off value of RET-He 29.2 pg were obtained to assess iron supplementation target in CKD-HD patients with sensitivity and specificity were 95.5% and 94% respectively."

"Anemia gizi merupakan salah satu dari 4 masalah gizi utama di Indonesia yang harus mendapatkan perhatian dan penanggulangan secara serius. Laporan hasil Riset Kesehatan Dasar (RISKESDAS) (2007) menunjukkan bahwa prevalensi anemia pada tahun 2007 di Jawa Barat untuk perempuan dewasa sebesar 13,4% dan laki-laki dewasa sebesar 7,4% melebihi rata-rata prevalensi nasional 11,9%. Hasil penelitian pada kelompok dewasa di Depok menunjukkan angka anemia yang cukup tinggi yaitu pada wanita dewasa sebesar 16,9%, dan laki-laki sebesar 7,8%. Penelitian ini bertujuan mengetahui hubungan antara karakteristik individu, asupan zat gizi dengan status hemoglobin, menggunakan data sekunder dari penelitian Riset Unggulan UI. Penelitian ini dilakukan pada kelompok usia dewasa di wilayah kota dan desa Depok, desain penelitiannya adalah cross sectional. Hasil penelitian menunjukkan bahwa rata- rata kadar hemoglobin (Hb) pada orang dewasa di Depok untuk wilayah urban (kota) adalah 14,1 gr/dl dan di rural (desa) 13,7 gr/dl. Untuk wilayah urban (kota) terdapat korelasi negatif antara frekuensi konsumsi pepaya ( r = -0,23 dan p = 0,04) dengan kadar Hb. Korelasi positif antara frekuensi konsumsi suplemen vitamin C ( r = 0,32 dan p = 0,004) dan kopi ( r = 0,23 dan p = 0,041) dengan kadar Hb. Sedangkan wilayah rural (desa) terdapat korelasi negatif antara umur (r= -0,23 dan p = 0,037) dengan kadar Hb. Korelasi positif antara frekuensi konsumsi daging sapi (r = 0,22 dan p = 0,048) dan tomat ( r = -0,252 dan p = 0,023) dengan kadar Hb. Sehingga dapat disimpulkan bahwa frekuensi konsumsi makanan pemicu dan penghambat absorbsi zat besi berhubungan dengan kadar hemoglobin baik di kota maupun di desa.

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Nutritional anemia is one of the four major nutrition problems in Indonesia that should get serious attention and response. Report of Health Research Association (RISKESDAS) (2007) showed that the prevalence of anemia in 2007 in West Java for 13,4% of adult women and men of 7,4% exceeds the average national prevalence of 11,9%. The results of research on adult groups in Depok indicate a fairly high rates of anemia in adult women is 16,9%, and males by 7,8%. This study aims to determine the relationship between individual characteristics and nutrient intake with the status of hemoglobin, using secondary data from Competitive research studies UI. The research was conducted on adult age groups in urban and rural in Depok, the research design is cross sectional.

The results showed that average levels of hemoglobin (Hb) in adults in Depok to urban areas (cities) was 14.1 g / dl and in the rural (village) 13.7 g / dL. For urban areas (cities) there is a negative correlation between the frequency of consumption of papaya with Hb (r = -0.23 and p = 0.04). Positive correlation between frequency of consumption of vitamin C supplement (r = 0.32 and p = 0.004) and coffee (r = 0.23 and p = 0.041) with Hb. While for the rural areas (villages) there is a negative correlation between age (r = -0.23 and p = 0.037) with Hb. Positive correlation between frequency of consumption of beef (r = 0.22 and p = 0.048) and tomato (r = -0.252 and p = 0.023) with Hb. So it can be concluded that the frequency of consumption of food enhancer and inhibiting the absorption of iron associated with hemoglobin levels in both urban and rural."

"Kurangnya pengetahuan ibu hamil tentang tablet tambah darah berkontribusi terhadap ketidakpatuhan terapi. Leaflet dan SMS reminder merupakan media yang dapat digunakan untuk meningkatkan kepatuhan terapi. Penelitian bertujuan untuk menilai efektifitas pemberian SMS reminder dibandingkan leaflet terhadapkepatuhan minum tablet tambah darah dan kadar hemoglobin ibu hamil. Penelitian merupakan eksprimen semu, prospektif, menggunakan dua kelompok intervensiyang tidak berpasangan dengan pre test-post test group design. Penelitian dilakukan di dua Puskesmas kota Depok pada bulan Maret-Mei 2016. Sebanyak 38 respondenibu hamil di Puskesmas Sukmajaya mendapatkan leaflet dan 36 responden ibu hamil di Puskesmas Pancoran Mas mendapatkan SMS reminder. Pengukuran kepatuhan menggunakan kuesioner MMAS-8. Kadar hemoglobin diukur dengan HemoCue®. Pemberian leaflet meningkatkan kepatuhan responden secara bermakna (P = 0,018) tetapi tidak bermakna meningkatkan kadar hemoglobin ratarata(P = 0,553). 19 responden kelompok leaflet mengalami kenaikan kadar hemoglobin dengan rata-rata kenaikan 0,6 g/dl. Pemberian SMS reminder tidak meningkatkan kepatuhan responden dan kadar hemoglobin secara bermakna (P = 0,180 dan P = 0,798). 17 responden kelompok SMS reminder mengalami kenaikan kadar hemoglobin dengan rata-rata kenaikan 1,1 g/dl. Tidak terdapat perbedaan yang bermakna antara pemberian leaflet dan SMS reminder terhadap peningkatan kepatuhan dan kadar hemoglobin responden (P = 0,576 dan P = 0,929).

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Lack of knowledge among pregnant women about iron supplementation contributes to poor compliance to the therapy. The use of media such as leaflet and SMS reminder can be used to improve compliance. This study aims to assess effectiveness of SMS reminder than leaflet on compliance of iron supplementation and hemoglobin level in pregnant women. This was a quasi-experimental study, prospectives, using two intervention groups with a pretest-posttest group design. The study was conducted between March and May 2016 in two public health center in Depok city. A total of 38 respondents in Sukmajaya get a leaflet and 36 respondents in Pancoran Mas get SMS reminders. Patient's compliance was measured by MMAS-8 quesionaire. Hemoglobin level was measured by HemoCue®. Leaflet improved patient's compliance significantly (P=0,018) but did not significantly increase the average hemoglobin level (P=0,553). 19 respondents in leaflet group experienced an increase in hemoglobin levels with an average 0.6 g/dl. SMS reminder didn't improve patient’s compliance neither did hemoglobin level significantly (P=0,180 dan P=0,798). 17 respondents in SMS reminder group experienced an increase in hemoglobin levels with an average 1.1 g/dl. There were no difference between leaflet and SMS reminder to improve patient’s compliance and hemoglobin level (P=0,576 dan P=0,929).

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"ABSTRACTThe overall objectives of this study is to examine whether a population of healthy University of Indonesia students have different hemoglobin distribution from that of American population and if there was difference whether it is appropriate to set up a new cut-off point for anemia as a screening tools for iron deficiency in population. This study is designed as a cross-sectional study using convenience sampling procedure. A total of 214 males and 190 females were studied from January to February 1997. After data cleaning, 203 healthy Indonesian males and 170 females were eligible for data analysis. Blood samples of the subjects was drawn to analyze hemoglobin and hematocrit level, red and white blood cell count, erythrocyte sedimentation rate, serum iron concentration and total iron binding capacity, serum ferritin and zinc protoporphyrin concentration. A structured questionnaire was administered to investigate factors that could influence hemoglobin level. The mean hemoglobin was compared with that of the United States population using results of NHANES III. The result showed that the mean hemoglobin of Indonesian male was the same with the American population in NHANES Ill. While for female there are difference in mean hemoglobin between the Indonesian and American, which could lead to different cutoff criteria for anemia. However when specificity and sensitivity of the new cutoff (Hb < 11.3 g/dl) and the WHO cutoff (Hb < 12 g/dI) were compared, the result showed that the latest had a more favorable sensitivity and specificity. Thus, this survey confirmed that there is no need to develop different cutoff points for anemia as a tool for iron deficiency screening."

"Latar belakang. Kemajuan terapi reperfusi pada pasien infark miokard akut menimbulkan satu fenomena yang turut berperan dalam prognosis pasien, yaitu fenomena no reflow atau obstruksi mikrovaskular. Mekanisme OMV diduga memiliki 4 komponen patogenik utama yaitu embolisasi distal aterotrombotik, cedera reperfusi, cedera iskemia, dan kerentanan individu. Hiperglikemia akut diketahui berhubungan dengan OMV pada pasien IMA, namun peran hiperglikemia kronik masih kontroversial. Hiperglikemia berperan dalam komponen kerentanan individu, serta mempengaruhi peningkatan faktor inflamasi yang berperan dalam komponen cedera reperfusi. Kedua faktor ini yaitu hiperglikemia kronik yang digambarkan HbA1C dan inflamasi yang digambarkan hsCRP belum pernah diteliti secara bersamaan dalam menilai OMV dengan satu metode. Penelitian ini akan meneliti hubungan antara HbA1C dan hsCRP dengan OMV yang dinilai menggunakan indeks resistensi mikrovaskular, suatu metode terbaru dalam menilai OMV dengan akurat pada fase awal dan memiliki nilai prognostik yang signifikan. Metode. Sebanyak 55 pasien IMA-EST yang menjalani IKPP dipilih secara konsekutif sejak Januari-Juni 2014. HbA1C dan hsCRP diambil saat masuk UGD, penilaian IMR diambil segera setelah tindakan IKPP. Perhitungan statistik menggunakan SPSS 17. Hasil. Dari 55 pasien didapatkan proporsi laki-laki sebesar 93%, dengan rerata umur 51,91 ± 8,87 tahun. Faktor resiko penyakit jantung koroner terbanyak adalah merokok yaitu 69%. Semua pasien menjalani tindakan IKPP dengan waktu iskemia 489,45±169,95 menit dan waktu perfusi 124,91±76,49 menit. Nilai rerata IRM 53,22±41,11 dengan nilai rerata HbA1C 6,46±1,22 %, dan rerata hsCRP 4,98±3,39 mg/dL. Dari analisis bivariat didapatkan HbA1C tidak berhubungan dengan IRM (r=0,22,p=0,10), dan hsCRP juga tidak berhubungan dengan IRM (r=0,24,p=0,08). Setelah disesuaikan dengan variabel perancu pada analisis multivariat, didapatkan hubungan signifikan antara HbA1C dengan IRM (p=0,03) namun hsCRP tidak berhubungan dengan IRM (p=0,31). Kesimpulan. Kadar HbA1C saat admisi berhubungan dengan IRM pada pasien IMA-EST yang menjalani IKPP dan hsCRP saat admisi tidak berhubungan dengan IRM pasien IMA-EST yang menjalani IKPP.

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Background: Advances in reperfusion therapy for acute myocardial infarction led to a phenomenon of distal no reflow or myocardial obstruction (MVO), which associated with worse outcome and prognosis. The potential mechanism of MVO had four major pathogenic components: distal atherotrombotic embolization, reperfusion injury, ischemic injury, and individual susceptibility. Association between acute hyperglycemia and MVO in acute myocardial infarction has been found, but the role of chronic hyperglycemia remained controversial. Hyperglycemia affected individual susceptibility to microcirculatory injury, and also induced systemic inflammation which had a role in reperfusion injury. Association of both these factors--chronic hyperglycemia, determined by Hemoglobin A1C, and inflammation factor, measured by high sensitivity C-Reactive Protein-- with MVO had never been studied simultaneously. This cross-sectional study will determine the association between HbA1C and hsCRP with MVO assessed with index of microvascular resistance, an invasive novel method to assess MVO in acute phase and had significant prognostic factor.

Methods: 55 patients with acute ST-elevation myocardial infarction underwent primary percutaneous coronary intervention were taken consecutively from January to June 2014. Blood samples for HbA1C and hsCRP were taken before the procedure. IMR was taken immediately after the primary percutaneous coronary intervention procedure. Statistical calculation used SPSS 17.

Results: From 55 patients included in the study, there were 93% men, with mean age of 51.91 ± 8.87 years. The most common risk factors for coronary heart disease was smoking (69%). All patients underwent primary percutaneous coronary intervention with mean onset to balloon time was 489.45 ± 169.95 minutes and mean door to balloon time was 124.91 ± 76.49 minutes. Mean IMR was 53.22 ± 41.11, with mean HbA1c was 6.46 ± 1.22% and mean hsCRP was 4.98 ± 3.39 mg/dL . From bivariate analysis, there was no association between HbA1C and IMR (r=0,22, p = 0,10), and between hsCRP and IMR (r = 0,24 , p=0,08). In multivariate analysis , there was relationship between HbA1C with IRM ( p = 0,03) and hsCRP were also not associated with IRM ( p = 0,31 ).

Conclusions. There was association between hemoglobin A1C levels on admission with IMR and no association between hsCRP levels on admission with IMR, in patients with acute ST-elevation myocardial infarction underwent primary percutaneous coronary intervention."

"[ABSTRAKLatar Belakang: Penghitungan Estimated Blood Loss (EBL) berdasarkan rumus Allowable Blood Loss (ABL) dengan target hemoglobin tertentu, kerap dijadikan panduan untuk memutuskan secara cepat transfusi intraoperatif. Penghitungan EBL mengandalkan penilaian visual sulit untuk distandardisasi. Seiring perkembangan teknologi, Point of Care Testing (POCT) makin memudahkan pemeriksaan hemoglobin. Penelitian ini bertujuan membandingkan akurasi penghitungan hemoglobin intraoperatif antara EBL dan POCT, dibandingkan dengan Hematology Analyzer yang merupakan pengukuran baku di laboratorium. Metode: Penelitian ini menggunakan Uji Bland-Altman pada pengukuran hemoglobin intraoperatif terhadap pasien yang menjalani operasi elektif yang diperkirakan mengalami banyak perdarahan dan memerlukan transfusi, di Instalasi Bedah Pusat (IBP) RSUPN Cipto Mangunkusumo, antara Desember 2014 hingga Maret 2015. Subjek penelitian dipilih dengan metode consecutive sampling. Saat penghitungan EBL mencapai ABL dengan target Hb 7 g/dL sebelum transfusi diberikan, sampel darah diambil untuk pengukuran hemoglobin dengan Sysmex XE-2100® sebagai Hematology Analyzer dan HemoCue® Hb 201+ sebagai POCT. Hasil: Sebanyak 43 subjek diikutsertakan dalam penelitian. Uji Bland-Altman Hb ABL (7 g/dL) terhadap Hb Sysmex. Interval yang dianggap akurat terhadap kadar Hb 7 g/dL adalah -1 hingga 1, diperoleh limits of agreement yang besar yaitu -2,267 hingga 2,467. Uji Bland-Altman Hb HemoCue terhadap Hb Sysmex, diperoleh limits of agreement yang kecil yaitu -0.418 hingga 0.372. Simpulan: Terdapat perbedaan bermakna dalam akurasi penghitungan hemoglobin intraoperatif antara EBL dengan Hematology Analyzer, sedangkan pengukuran dengan HemoCue® Hb 201+ sebagai perangkat POCT, mempunyai keakuratan yang baik. EBL berdasarkan rumus ABL dengan target Hb 7 g/dL tidak bisa digunakan untuk pengambilan keputusan transfusi intraoperatif karena tidak mempunyai keakuratan yang baik.

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ABSTRACTBackground: Measurement of Estimated Blood Loss (EBL) based on the Allowable Blood Loss (ABL) formula with certain hemoglobin target is often used as a guidance to make a fast decision for intraoperative transfusion. Measurement of EBL relies on visual assessment is difficult to standardized and a new technique called Point of Care Testing (POCT) offered easier way to measure haemoglobin. This study aimed to compare the accuracy of the intraoperative hemoglobin measurement by EBL and POCT with Hematology Analyzer in the laboratory as a golden standard. Methods: This study used a Bland-Altman test on intraoperative hemoglobin measurement in patients undergoing elective surgery which was expected to experience a lot of bleeding and require blood transfusions in Center Operating Theater of Cipto Mangunkusumo Hospital from December 2014 until March 2015. Subjects were selected by consecutive sampling method. When EBL had reached ABL with a Hb level target 7 g / dL before transfusion was given, blood samples were taken for measurement of hemoglobin with Sysmex XE-2100® as Hematology Analyzer and HemoCue® Hb 201+ as POCT. Results: A total of 43 subjects were included in the study. Bland-Altman analysis of Hb EBL (7 g / dL) to Hb Hematology Analyzer with interval considered as accurate for Hb 7 g / dL was -1 to 1, revealed wide limits of agreement (-2.267 to 2.467). Bland-Altman analysis of Hb POCT to Hb Hematology Analyzer revealed narrow limits of agreement (-0418 to 0372). Conclusion: There was a significant difference in the accuracy of intraoperative hemoglobin measurement by EBL compared to Hematology Analyzer, while the measurement by POCT device had good accuracy. EBL based on the formula ABL with a Hb level target 7 g / dL could not be used for intraoperative transfusion decision making because it did not has good accuracy., Background: Measurement of Estimated Blood Loss (EBL) based on the formulaAllowable Blood Loss (ABL) with certain hemoglobin target, is often used as aguidance to make a quick decision for intraoperative transfusion. Measurement ofEBL relies on visual assessment cannot be standardized. As developingtechnology, Point of Care Testing (POCT) makes hemoglobin measurementeasier. This study aimed to compare the accuracy of the intraoperativehemoglobin measurement by EBL and POCT with Hematology Analyzer in thelaboratory as a golden standard.Methods: This study used a Bland-Altman test on intraoperative hemoglobinmeasurement in patients undergoing elective surgery that was expected toexperience a lot of bleeding and need transfusion in Center Operating Theater ofCipto Mangunkusumo Hospital from December 2014 until March 2015. Subjectswere selected by consecutive sampling method. When EBL had reached ABLwith a Hb level target 7 g / dL before transfusion was given, blood samples weretaken for measurement of hemoglobin with Sysmex XE-2100® as HematologyAnalyzer and HemoCue® Hb 201+ as POCT.Results: A total of 43 subjects were included in the study. Bland-Altman analysisof Hb EBL (7 g / dL) to Hb Hematology Analyzer with interval considered asaccurate for Hb 7 g / dL was -1 to 1, revealed wide limits of agreement (-2.267 to2.467). Bland-Altman analysis of Hb POCT to Hb Hematology Analyzer revealednarrow limits of agreement (-0418 to 0372).Conclusion: There was a significant difference in the accuracy of intraoperativehemoglobin measurement by EBL compared to Hematology Analyzer, while themeasurement by POCT device had good accuracy. EBL based on the formulaABL with a Hb level target 7 g/dL could not be used for intraoperative transfusion decision making because it did not has good accuracy.]"

"Pemeriksaan hemoglobin umum dilakukan secara invasif menggunakan berbagai metode, seperti automated hematology analyzer dan hemoglobinometer. Akan tetapi metode tersebut memakan waktu, biaya, dan menyakitkan bagi pasien. Pemeriksaan hemoglonin secara invasif juga tidak memungkinkan untuk dilakukan secara real-time dalam situasi mendesak. Akurasi dan ketepatan pembacaan menjadi tantangan dalam pengembangan sistem pengukur konsentrasi hemoglobin non-invasif. Pada penelitian ini dilakukan pengembangan dua desain sistem pengukur hemoglobin non-invasif (desain prototipe A dan desain prototipe B) menggunakan prinsip photoplethysmography (PPG) menggunakan sensor MAX30102 dan Arduino Uno sebagai mikrokontroler. Pengembangan prototipe dibuat berbasis machine learning dengan menggunakan model Dense Neural Network (DNN) dan menunjukkan akurasi paling maksimal menggunakan MSE loss function sebesar 92,31% untuk desain prototipe A dan 94,70% untuk desain prototipe B. Didapatkan juga hasil pengukuran reliabilitas alat ukur untuk desain prototipe A dan B masing-masing sebesar 84,90% dan 97,30%. Meski sudah memiliki tingkat akurasi yang cukup baik, penelitian ini masih perlu dikembangkan dari segi pemilihan alat referensi pemeriksaan Hb invasif, pengambilan dan pengolahan data yang lebih bervariasi mencakup usia, warna kulit, dan penyakit yang sedang dialami.

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Hemoglobin examination is commonly conducted invasively using various methods such as automated hematology analyzers and hemoglobinometers. However, these methods are time-consuming, costly, and painful for patients. Invasive hemoglobin examinations also do not allow real-time measurements in urgent situations. Accuracy and precision of readings pose challenges in the development of non-invasive hemoglobin concentration measurement systems. In this study, the development of two designs of non-invasive hemoglobin measurement systems (prototype design A and prototype design B) using photoplethysmography (PPG) principle with MAX30102 sensor and Arduino Uno as the microcontroller was conducted. Prototype development was based on machine learning using a Dense Neural Network (DNN) model and achieved maximum accuracy using MSE loss function of 92,31% for prototype design A and 94,70% for prototype design B. The measurement reliability of the measurement device was also obtained, with 84,90% for prototype design A and 97,30% for prototype design B, respectively. Although the study already achieved a relatively good level of accuracy, further development is still needed in terms of selecting invasive Hb examination reference devices, obtaining and processing more diverse data including age, skin color, and existing diseases."

"Ruang Lingkup dan Cara Penelitian: Populasi Melayu di propinsi Sumatera Selatan memiliki frekuensi pembawa sifat thalassemia-R sebesar 9% (tertinggi di Indonesia) dan frekuensi Hb E sebesar 6% (Sofro, 1995). Oleh karena itu diperlukan program pencegahan thalassemia-3 berupa skrining pembawa sifat yang efektif dan efisien dengan biaya relatif murah serta spesifik untuk populasi Melayu di Sumatera Selatan, konsultasi genetik, dan diagnosis prenatal. Dengan latar belakang tersebut, dilakukan penelitian yang bertujuan untuk: (1) Menentukan nilai MCV dan MCH yang paling optimal untuk skrining pembawa sifat thalassemia-P pada populasi Melayu di Sumatera Selatan, (2) Mengetahui spektrum mutasi pembawa sifat thalassemia-P pada populasi Melayu di Sumatera Selatan, dan (3) Memperoleh kemampuan untuk memprediksi jenis mutasi thalassemia-R hanya berdasarkan nilai hematologi dan hasil analisis Hb. Pendekatan yang dilakukan terdiri dari skrining dan pengelompokan data nilai hematologi dan analisis Hb, analisis DNA dengan menggunakan teknik PCR﷓RFLP, ARMS, dan sekuensing, serta analisis korelasi terhadap hasil pemeriksaan.Hasil dan kesimpulan: Frekuensi pembawa sifat thalassemia-P pada populasi Melayu di Sumatera Selatan didapatkan sebesar 8% (termasuk Hb E). Hasil ini mengoreksi studi Sofro yang pemah dilaporkan sebelumnya. Pada penelitian ini direkomendasikan nilai MCV < 80 fL dan MCH < 27 pg untuk skrining pembawa sifat thalassemia-p pada populasi Melayu di Sumatera Selatan. Spektrum mutasi thalassemia-P pada populasi Melayu di Sumatera Selatan didominasi oleh Hb E (36,3%) dan Hb Malay (34,1%) yang merupakan jenis mutasi thalassemia-R+ ringan sehingga permasalahan thalassemia-p di propinsi Sumatera Selatan tidak sebesar yang diperkirakan. Nilai MCV dan MCH juga dapat digunakan untuk prediksi jenis mutasi thalassemia-43. Sedangkan kadar Hb A2 tidak dapat digunakan untuk prediksi jenis mutasi thalassemia-P. Kadar Hb tidak berperan dalam skrining pembawa sifat thalassemia-II."