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"Kanker kolorektal (KKR) adalah kanker tersering nomor tiga di dunia yang memiliki angka mortalitas tinggi terutama di negara berkembang, termasuk Indonesia. Angka mortalitas yang tinggi disebabkan penegakan diagnosis sudah pada stadium lanjut. Kolonoskopi merupakan baku emas diagnosis KKR, namun bersifat invasif, tidak nyaman, dan berisiko komplikasi. Inflamasi kronis diketahui terjadi pada KKR dan berperan pada perkembangan dan metastasis sel kanker. Parameter hematologi seperti red cell distribution width (RDW), Rasio Hemoglobin-RDW (RHR), dan Rasio RDW-Trombosit (RRT) memberi informasi yang bermakna pada pasien KKR. Penelitian ini bertujuan untuk menilai peran RDW, RHR, dan RRT dalam membedakan kelompok KKR dan non-KKR. Desain penelitian potong lintang dengan total 78 pasien tersangka KKR, terdiri dari 39 kelompok KKR dan 39 kelompok non-KKR yang dilakukan pemeriksaan kolonoskopi dan histopatologi. Didapatkan perbedaan bermakna nilai RDW, RHR, dan RRT pada kelompok KKR dan non-KKR. Titik potong nilai RDW, RHR, dan RRT untuk membedakan kelompok KKR dari non-KKR berturut-turut adalah 14,5 (sensitivitas 74,4% dan spesifisitas 66,7%), 0,77 (sensitivitas 76,9% dan spesifisitas 66,7%), 0,045 (sensitivitas 61,5% dan spesifisitas 66,7%). Berdasarkan analisis multivariat, model kombinasi parameter laboratorium RHR dan RRT dengan parameter klinis penurunan berat badan memiliki probabilitas 90,44% dalam diagnosis KKR pada pasien tersangka KKR.

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Colorectal cancer (CRC) is the third most common cancer in the world with high mortality rate, especially in developing countries including Indonesia. The high mortality rate is due to the late diagnosis at advanced stage. Colonoscopy is the gold standard for CRC diagnosis, but invasive, uncomfortable and carries a risk of complications. Chronic inflammation is known to occur in CRC and plays a role in the development and metastasis of cancer cells. Hematological parameters such as red cell distribution width (RDW), Hemoglobin-RDW Ratio (HRR), and RDW-Platelet Ratio (RPR) provide significant information in CRC patients. This study aims to assess the role of RDW, RHR, and RRT in differentiating CRC from non-CRC groups. Cross-sectional study was conducted in 78 suspected CRC patients, consisting of 39 CRC and 39 non-CRC subjects who underwent colonoscopy and histopathology examinations. Significant differences were found in RDW, HRR, and RPR between the CRC and non-CRC groups. The cut-off points for RDW, HRR, and RPR to distinguish the CRC from non-CRC groups were 14.5 (sensitivity 74.4% and specificity 66.7%), 0.77 (sensitivity 76.9% and specificity 66.7%), 0.045 (sensitivity 61.5% and specificity 66.7%), respectively. Based on multivariate analysis, a diagnostic model based on the combination of laboratory parameters such as HRR and RPR with clinical parameter of weight loss has a 90.44% probability in diagnosing CRC in suspected CRC patients."

"[ABSTRAKAnemia defisiensi besi dan thalassemia β trait merupakan penyebabtersering anemia mikrositik hipokrom di Indonesia. Kedua penyakit tersebut sulitdibedakan hanya dengan pemeriksaan hematologi, oleh karena itu diperlukanpemeriksaan tambahan seperti feritin dan analisis hemoglobin. Namun tidak semualaboratorium dapat melakukan pemeriksaan ini. Banyak penelitian yangmembedakan kedua penyakit tersebut dengan indeks eritrosit. Namun indekseritrosit memiliki nilai diagnostik yang berbeda di setiap negara dan belum ada datadi Indonesia. Penelitian ini melakukan uji diagnostik Indeks Mentzer, RDW, Green-King, Sirdah, dan mencari nilai cut-off baru yang memberikan nilai diagnostik lebihbaik.Penelitian terdiri dari 98 subyek definitif anemia defisiensi besi dan 80subyek thalassemia β trait. Nilai diagnostik Indeks Mentzer untuk anemia defisiensibesi adalah sensitivitas 83.6%, spesifisitas 66.2%, NPP 75.2%, NPN 76.8%, RKP2.4, RKN 0.2. Nilai diagnostik Indeks Mentzer untuk thalassemia β trait adalahsensitivitas 66.2%, spesifisitas 83.6%, NPP 76.8%, NPN 75.2%, RKP 4.0, RKN0.4. Nilai diagnostik Indeks RDW untuk anemia defisiensi besi adalah sensitivitas91.8%, spesifisitas 75%, NPP 81.8%, NPN 88.2%, RKP 3.6, RKN 0.1. Nilaidiagnostik Indeks RDW untuk thalassemia β trait adalah sensitivitas 75%,spesifisitas 91.8%, NPP 88.2%, NPN 81.8%, RKP 9.1, RKN 0.2. Nilai diagnostikIndeks Green-King untuk anemia defisiensi besi adalah sensitivitas 96.9%,spesifisitas 67.5%, NPP 78.5%, NPN 94.7%, RKP 2.9, RKN 0.04. Nilai diagnostikIndeks Green-King untuk thalassemia β trait adalah sensitivitas 67.5%, spesifisitas96.9%, NPP 94.7%, NPN 78.5%, RKP 22.0, RKN 0.3. Nilai diagnostik IndeksSirdah untuk anemia defisiensi besi adalah sensitivitas 92.8%, spesifisitas 58.7%,NPP 73.3%, NPN 87.0%, RKP 2.2, RKN 0.1.Nilai diagnostik Indeks Sirdah untukthalassemia β trait adalah sensitivitas 58.7%, spesifisitas 92.8%, NPP 87.0%, NPN73.3%, RKP 8.2, RKN 0.4. Nilai cut-off baru Indeks Mentzer adalah 13.44, RDWI233.4, Green-King 75.06, dan Sirdah 32.52.Keempat indeks eritrosit dapat diaplikasikan untuk orang Indonesia denganIndeks Green-King sebagai indeks yang terbaik.

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ABSTRACTIron deficiency anemia and β trait thalassemia are the most common causesof microcytic hypochromic anemia in Indonesia. Differentiation between them isdifficult when solely based on a hematology examination, so additional laboratorytests are required such as ferritin and hemoglobin analysis. However, not alllaboratories can perform these tests. Many erythrocytes indices have been proposedto determine whether a blood sample is more suggestive for iron deficiency anemiaor β trait thalassemia. Unfortunately these indices have different diagnostic valuein many countries and there is no data about diagnostic value in Indonesia. Thisstudy performs diagnostic test Mentzer, RDW, Green-King, and Sirdah Index anddevelops a new cut-off point that could make a better diagnostic value.This study consists of 98 subjects of iron deficiency anemia and 80 subjectsof β trait thalassemia. Diagnostic values of Mentzer Index for iron deficiencyanemia were sensitivity 83.6%, specificity 66.2%, PPV 75.2%, NPV 76.8%, LR+2.4, LR- 0.2. Diagnostic values of Mentzer Index for β trait thalassemia weresensitivity 66.2%, specificity 83.6%, PPV 76.8%, NPV 75.2%, LR+ 4.0, LR- 0.4.Diagnostic values of RDW Index for iron deficiency anemia were sensitivity91.8%, specificity 75%, PPV 81.8%, NPV 88.2%, LR+ 3.6, LR- 0.1. Diagnosticvalues of RDW Index for β trait thalassemia were sensitivity 75%, specificity91.8%, PPV 88.2%, NPV 81.8%, LR+ 9.1, LR- 0.2. Diagnostic values of Green-King Index for iron deficiency anemia were sensitivity 96.9%, specificity 67.5%,PPV 78.5%, NPV 94.7%, LR+ 2.9, LR- 0.04. Diagnostic values of Green-KingIndex for β trait thalassemia were sensitivity 67.5%, specificity 96.9%, PPV 94.7%,NPV 78.5%, LR+ 22.0, LR- 0.3. Diagnostic values of Sirdah Index for irondeficiency anemia were sensitivity 92.8%, specificity 58.7%, PPV 73.3%, NPV87.0%, LR+ 2.2, LR- 0.1. Diagnostic values Sirdah Index for β trait thalassemiawere sensitivity 58.7%, specificity 92.8%, PPV 87.0%, NPV 73.3%, LR+ 8.2, LR-0.4. The new cut-off point of Mentzer, RDW, Green-King, and Sirdah Index was13.44, 233.4, 75.06, and 32.52 respectively.All indices can be applied for Indonesian people, among which Green-KingIndex had the best diagnostic value, Iron deficiency anemia and β trait thalassemia are the most common causesof microcytic hypochromic anemia in Indonesia. Differentiation between them isdifficult when solely based on a hematology examination, so additional laboratorytests are required such as ferritin and hemoglobin analysis. However, not alllaboratories can perform these tests. Many erythrocytes indices have been proposedto determine whether a blood sample is more suggestive for iron deficiency anemiaor β trait thalassemia. Unfortunately these indices have different diagnostic valuein many countries and there is no data about diagnostic value in Indonesia. Thisstudy performs diagnostic test Mentzer, RDW, Green-King, and Sirdah Index anddevelops a new cut-off point that could make a better diagnostic value.This study consists of 98 subjects of iron deficiency anemia and 80 subjectsof β trait thalassemia. Diagnostic values of Mentzer Index for iron deficiencyanemia were sensitivity 83.6%, specificity 66.2%, PPV 75.2%, NPV 76.8%, LR+2.4, LR- 0.2. Diagnostic values of Mentzer Index for β trait thalassemia weresensitivity 66.2%, specificity 83.6%, PPV 76.8%, NPV 75.2%, LR+ 4.0, LR- 0.4.Diagnostic values of RDW Index for iron deficiency anemia were sensitivity91.8%, specificity 75%, PPV 81.8%, NPV 88.2%, LR+ 3.6, LR- 0.1. Diagnosticvalues of RDW Index for β trait thalassemia were sensitivity 75%, specificity91.8%, PPV 88.2%, NPV 81.8%, LR+ 9.1, LR- 0.2. Diagnostic values of Green-King Index for iron deficiency anemia were sensitivity 96.9%, specificity 67.5%,PPV 78.5%, NPV 94.7%, LR+ 2.9, LR- 0.04. Diagnostic values of Green-KingIndex for β trait thalassemia were sensitivity 67.5%, specificity 96.9%, PPV 94.7%,NPV 78.5%, LR+ 22.0, LR- 0.3. Diagnostic values of Sirdah Index for irondeficiency anemia were sensitivity 92.8%, specificity 58.7%, PPV 73.3%, NPV87.0%, LR+ 2.2, LR- 0.1. Diagnostic values Sirdah Index for β trait thalassemiawere sensitivity 58.7%, specificity 92.8%, PPV 87.0%, NPV 73.3%, LR+ 8.2, LR-0.4. The new cut-off point of Mentzer, RDW, Green-King, and Sirdah Index was13.44, 233.4, 75.06, and 32.52 respectively.All indices can be applied for Indonesian people, among which Green-KingIndex had the best diagnostic value]"

"Paparan terhadap polutan, terutama asap rokok merupakan penyebab peradangan saluran napas kronis pada PPOK. Pada penelitian sebelumnya, piroksikam terbukti menghambat aktivasi neutrofil dan mengurangi pelepasan anion superoksida dari neutrofil melalui ikatannya dengan formyl peptide receptor (FPR) secara in vitro. Penelitian ini dilakukan untuk menganalisis efek antagonis FPR1 piroksikam secara in vivo terhadap parameter hematologi dan red blood’s cell distribution width (RDW). Penelitian ini menggunakan mencit betina ddY. Mencit diinduksi dengan asap rokok selama delapan minggu. Mencit yang sudah mengalami PPOK dibagi menjadi enam kelompok. Kelompok negatif diberi CMC-Na 0,5% secara oral, kelompok positif diberikan inhalasi budesonid 0,002mg/20gBB mencit/hari, serta tiga kelompok variasi dosis piroksikam dengan D1 0,026mg/20gBB mencit/hari; D2 0,052mg/20gBB mencit/hari; dan D3 0,104mg/20gBB mencit/hari secara oral. Mencit diinduksi selama delapan minggu, lalu diberikan perlakuan selama 21 hari. Parameter yang dinilai adalah hematologi serta red blood cell’s distribution width (RDW) yang diukur menggunakan hematology analyzer. Dosis 0,026mg/20gBB dan 0,104mg/20gBB memiliki efek terhadap parameter hematologi. Dosis 0,026mg/20gBB, 0,052mg/20gBB, dan 0,104mg/20gBB dapat menurunkan RDW. Berdasarkan penelitian, piroksikam memiliki efek terhadap parameter hematologi dan dapat menurunkan red blood cell’s distribution width (RDW).

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Exposure to pollutants, especially cigarette smoke, is a cause of chronic airway inflammation in COPD. In a previous study, piroxicam was found to inhibit neutrophil activation and reduce the release of superoxide anion from neutrophils by binding to formyl peptide receptor (FPR) in vitro. This study was conducted to analyze the effect of the FPR1 antagonist piroxicam in vivo on hematological parameters and red blood's cell distribution width (RDW). This study used female DDY mice. Mice were induced with cigarette smoke for eight weeks. COPD Mice were divided into six groups. The negative group was given CMC-Na 0,5% orally, the positive group was given inhaled budesonide 0,002mg/20gBW mice/day, and the three variation dose groups of piroxicam with D1 0.026mg/20gBW mice/day; D2 0,052mg/20gBW mice/day; and D3 0,104mg/20gBW mice/day orally. Mice were induced for eight weeks, then given treatment for 21 days. The parameters assessed were hematology and red blood cell's distribution width (RDW) which was measured using a hematology analyzer. Doses 0.026mg/20gBW and 0.104mg/20gBW of piroxicam affect hematological parameters. Doses 0.026mg/20gBW, 0.052mg/20gBW, and 0.104mg/20gBW of piroxicam are able to reduce RDW. The results showed that piroxicam affects hematological parameters and reduces red blood cell’s distribution width (RDW).

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