Hasil Pencarian  ::  Simpan CSV :: Kembali

"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.

---

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."

"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.

---

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.

---

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.

---

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."

"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.

---

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."

"[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.

---

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: Kondisi besi berlebih, dengan feritin dan saturasi transferin sebagai surrogate marker, akan menimbulkan oksigen radikal bebas (ROS) yang menyebabkan stress oksidatif. Malondialdehid (MDA) merupakan ROS yang terbentuk dari peroksidase lemak sedangkan (manganese)superoksid dismutase (MnSOD) sebagai enzim yang mengubah radikal bebas oksigen menjadi oksigen biasa. Transfusi darah sering digunakan untuk mengatasi anemia pada kanker, namun juga berpotensi meningkatkan beban besi pada tubuh. Penelitian ini melihat peran transfusi darah terhadap feritin serum dan saturasi transferin serta kaitannya dengan stres oksidatif pada pasien kanker nasofaring.Tujuan: Mengetahui peranan transfusi sel darah merah (SDM) dalam kaitannya dengan perubahan kadar feritin serum dan saturasi transferin serta korelasinya dengan stress oksidatif pada pasien kanker nasofaring (KNF) yang menjalani kemoradiasi.Metode: Studi kohort prospektif. Pengambilan data dilakukan di klinik Hematologi-Onkologi Medik IPD RSCM Jakarta secara consecutive sampling pada bulan November 2015-Februari 2016. Pasien KNF yang menjalani kemoradiasi diperiksakan kadar feritin serum, saturasi transferin, MDA, MnSOD pra dan pasca terapi. Dilakukan pencatatan jumlah transfusi sel darah merah yang diterima. Analisa data menggunakan T-test/Mann Whitney dan uji korelasi Spearman.Hasil: Total 38 pasien yang menjalani kemoradiasi, usia rata-rata 47 tahun, laki-laki dan perempuan 4:1. Sebanyak 18 pasien (47,4%) menerima transfusi sel darah merah selama pengobatan. Didapatkan peningkatan rerata saturasi transferin sebesar 15,1% (p=0,016) dan MDA sebesar 1,368 (p=0,001) pada pasien yang mendapatkan transfusi SDM dibandingkan yang tidak mendapatkan transfusi. Tidak didapatkan perbedaan yang signifikan pada feritin serum (p= 0,35) dan MnSOD (p= 0,496) antara yang mendapatkan transfusi SDM dengan yang tidak. Didapatkan korelasi lemah antara feritin serum dengan MDA dan MnSOD (r=0,239 dan r= -0,374) dan tidak didapatkan korelasi antara saturasi transferin dengan MDA dan MnSOD (r=0,191 dan r=0,027).Simpulan: Terdapat peningkatan rerata saturasi transferin dan MDA pada pasien yang mendapatkan transfusi SDM. Tidak terdapat peningkatan feritin serum ataupun penurunan MnSOD. Terdapat korelasi yang lemah antara peningkatan kadar feritin serum dengan MDA dan MnSOD pada pasien KNF pasca kemoradiasi dan transfusi sel darah merah. Tidak terdapat korelasi antara kadar saturasi transferin dengan MDA dan MnSOD pada pasien KNF yang mendapat transfusi sel darah merah.

---

Background: The presence of free iron in the circulation will induce the formation of reactive oxygen species (ROS) which result in cell injury. The free radical formed and cause lipid peroxidation which in result cause formation of malondialdehyde (MDA). (manganese)Superoxide Dismutase (MnSOD) as antioxidant enzyme have anti tumor activity and the level often found low in cancer patient. Ferritin and transferrin saturation are predictor of iron overload. Blood transfusion is the therapy often used to resolve anemia in cancer, but also increase iron burden in body. This study focus on the role of blood transfusion to serum ferritin and transferrin saturation and its correlation with oxidative stress in patients with nasopharyngeal cancer (NPC).

Objective: To know the role of red blood cell (RBC) transfusion and its relations to serum ferritin and transferin saturation level and their correlation with oxidative stress in nasopharyngeal cancer patients undergoing chemoradiation.

Methods: Prospective study. Sample obtained with consecutive sampling method collected in the Hematology-Medical Oncology Clinic in Cipto Mangunkusumo Hospital Jakarta November 2015 to February 2015. NPC patients undergoing chemoradiation, blood examination performed to measure ferritin, saturation transferrin, malondialdehyde, MnSOD before and after treatment. During treatment the amount of transfusion received is recorded. Data analysis done using T-test/Mann Whitney and Spearman correlation test.

Results: Total of 38 patients received chemoradiation, mean age 47,97 years old, proportion man compare woman is 4:1. During treatment 18 patients (47,4%) received red blood cell transfusion. Difference in mean found between transferrin saturation 15,1% (p=0,016) and MDA serum 1,358 nM (p=0,001) in patient receiving RBC transfusion compare to subject not receving transfusion. There are no significantly differences in serum ferritin and MnSOD level between both group. We found a weak correlation between raise of serum ferritin to the raise of MDA and the declining of MnSOD (r = 0,239 and r= -0,374). There are no correlation between transferin saturation with MDA nor MnSOD

Conclusions : Increase in transferin saturation and MDA level found in NPC receiving RBC transfusion after chemoradiation. There is a weak correlation found between serum ferritin with MDA and MnSOD in nasopharyngeal cancer undergoing chemotherapy radiation therapy receiving RBC transfusion and no correlation between transferin saturation with MDA and MnSOD changes."

"ABSTRAKLatar Belakang: Muatan besi berlebih akibat transfusi darah dan peningkatan serapan besi di saluran cerna, masih merupakan isu penting pada Thalasemia Intermedia TI , dan dikaitkan dengan berbagai komplikasi yang meningkatkan morbiditas dan mortalitas. Pemeriksaan MRI T2 hati sebagai pemeriksaaan yang tervalidasi dalam menilai Liver Iron Concentration LIC , merupakan pemeriksaan yang mahal dan tidak tersedia secara merata di Indonesia.Tujuan: Mengetahui gambaran muatan besi berlebih darah dan hati pada pasien thalasemia intermedia dewasa dan korelasi antara saturasi transferin, feritin serum, MRI T2 hati, dan LIC yang dinilai dengan pemeriksaan MRI T2 hati dengan nilai elastografi hati.Metode: Penelitian potong lintang pada pasien thalasemia intermedia dewasa dengan transfusi darah dan dengan atau tanpa kelasi besi di RSUPNCM dr. Cipto Mangunkusumo mulai dari bulan Agustus sampai dengan Oktober 2016, dengan total subyek penelitian sebanyak 45 orang. Dilakukan pemeriksaan saturasi transferin, feritin serum, elastografi hati, dan MRI T2 hati. Analisis statistik menggunakan uji korelasi Pearson dan Spearman.Hasil: Sebanyak 64,4 subyek penelitian adalah Thalasemia ?-Hb E, dengan median RIK umur 33 22 tahun. Sebanyak 84,4 subyek penelitian mendapatkan transfusi darah secara reguler. Seluruh subyek penelitian mengalami komplikasi hemosiderosis hati melalui pemeriksaan MRI T2 hati. Sebanyak 48,9 mengalami hemosiderosis hati berat, dengan nilai median MRI T2 hati 1,6 ms. rerata feritin serum adalah 2831 1828 ng/mL, dengan nilai median saturasi transferin 66 . Nilai rerata LIC melalui pemeriksaan MRI T2 adalah 15,36 7,37 mg besi/gr berat kering hati dan nilai rerata elastografi hati adalah 7,7 3,8 Kpa. Uji korelasi didaptakan terdapat korelasi nilai elastografi hati dan rerata feritin serum r = 0,651; p = 0,000 , nilai elastografi hati dan LIC r = 0,433; p = 0,003 dan korelasi negatif nilai elastografi hati dan MRI T2 hati r = -0,357; p = 0,016 .Simpulan: Terdapat korelasi antara muatan besi berlebih feritin serum dan LIC dengan nilai elastografi hati. Terdapat korelasi negatif nilai elastografi hati dengan MRI T2 hati pada pasien thalasemia intermedia dewasa.

---

ABSTRACTBackground Iron overload is a common feature of thalassemia intermedia due to regular blood transfusion and increase gastrointestinal iron absorption. Early detection and adequate iron chelator can significantly decrease related morbidities and mortality due to complication from iron overload. Liver Iron Concentration LIC is the best way to measure body iron stores. MRI T2 as a validated test to identify LIC, is expensive and currently not available in all medical services in Indonesia.Objective To identify liver iron overload and correlation of transferrin saturation, serum ferritin, liver MRI T2 , and LIC with transient liver elastography in adult thalassemia intermedia patient.Methods We conducted a cross sectional study enrolling 45 patients with thalassemia intermedia with blood transfusion and with and without iron chelator therapy. The study was conducted at Cipto Mangunkusumo Hospital from August 2016 through October 2016. We performed measurements of transferrin saturation, serum ferritin level, transient liver elastography and liver MRI T2 . The Pearson and Spearman correlation test were used to evaluate the correlation transient liver elastography with transferrin saturation, serum ferritin, Liver MRI T2 , and LIC.Results As much as 64,4 of study subject are Hb E Thalasemia Intermedia with median IQR age is 33 22 years old. As much as 84,4 of study subject have regular blood transfusion. On the basis of liver MRI T2 , all studi subject suffered from liver iron overload, with 48,9 had severe liver iron overload. The median value of Liver MRI T2 was 1,6 ms. The mean serum ferritin was 2831 1828 ng mL, with median value of transferrin saturation was 66 . The mean of LIC corresponding to Liver MRI T2 and mean liver stiffness measurement was 15,36 7,37 mg Fe gr dry weight and 7,7 3,8 Kpa respectively. Liver Stiffness correlated with serum ferritin r 0,651 p 0,000 , Liver MRI T2 r 0,357 p 0,016 , and LIC r 0,433 p 0,003 . No correlation was found between liver elastography and transferrin saturation r 0,204 p 0,178 .Conclusions Serum ferritin, Liver MRI T2 , and LIC correlated with liver elastography. No correlation was found between transferin saturation and liver elastography. "

"Latar Belakang: Talasemia merupakan kelainan sintesis hemoglobin yang membutuhkan transfusi darah berulang. Kombinasi terapi kelasi dan transfusi darah telah meningkatkan harapan hidup, namun menyebabkan penumpukan besi di organ tubuh seperti kelenjar endokrin. Hipogonadisme yang merupakan salah satu gangguan endokrin yang sering terjadi pada penderita talasemia, umumnya terjadi akibat penumpukan besi di jaringan hipofisis. Penumpukan besi di hipofisis dapat dilihat dengan melihat waktu relaksasi MRI T2 hipofisis.Tujuan: Penelitian ini bertujuan untuk melihat hubungan status besi dengan keadaan hipogonadisme yang dinilai dengan melihat korelasi serum feritin, saturasi transferin dan waktu relaksasi MRI T2 hipofisis dengan kadar FSH, LH dan testosteron.Metode: Penelitian ini merupakan studi potong lintang dengan subjek 32 penderita pria talasemia bergantung transfusi. Pengambilan sampel dilakukan secara konsekutif di poliklinikin talasemia Rumah Sakit Cipto Mangunkusumo. Pemeriksaan serum feritin, saturasi transferin, FSH, LH dan testosteron menggunakan teknik ELISA. Sedangkan pemeriksaan waktu relaksasi MRI T2 hipofisis menggunakan MRI Avanto 1,5 Tesla.Hasil: Pada penelitian ini didapatkan 62,5% pasien tidak mencapai pubertas sempurna. Didapatkan rerata kadar testosteron 23,31 (SB 15,57). Didapatkan 25% pasien memiliki testosteron rendah, dan dari kelompok tersebut seluruhnya memiliki kadar FSH dan LH yang rendah atau normal. Dijumpai adanya korelasi negatif lemah antara waktu relaksasi MRI T2 hipofisis dengan saturasi transferin pada kelompok dengan nilai testosteron normal. Korelasi pada variabel lainnya tidak terdapat yang signifikan.Simpulan: Angka kejadian pasien dengan pubertas tidak sempurna cukup tinggi, tidak sejalan dengan hasil laboratorium. Pada penelitian ini dijumpai korelasi negatif lemah antara saturasi transferin dengan waktu relaksasi MRI T2 hipofisis.

---

Background: Thalassemia is a disorder of haemoglobin synthesis that require regular blood transfusion. The combination of chelation therapy and blood transfusion has extended life expectancy. However, repetition of blood transfusions leads to accumulation of iron in organs such as endocrine glands. Hypogonadism is one of the most prevalent endocrine disorder in thalassemia, caused by iron deposition in pituitary gland. Iron overload in pituitary can be measured by pituitary MRI T2 relaxation time.

Objective: The purpose of this study was to see the correlation between iron overload with hypogonadal state by analyzing correlation between ferritin serum, transferrin saturation, pituitary MRI T2 relaxation time with FSH, LH and testosterone levels.

Methods: This is a cross-sectional study with 32 subjects of male transfusion-dependent thalassemia. The subjects were collected with consecutive sampling technique in thalassemia outpatient clinic in Rumah Sakit Cipto Mangunkusumo, Jakarta. Measurement of serum ferritin, transferrin saturation, FSH, LH and testosterone were done using ELISA technique. Pituitary MRI T2 relaxation time was done using MRI Avanto 1.5 Tesla.

Results: In this study, secondary sexual characteristics was not fully achieved in 62,5%. The mean of testosterone levels is 23,31 (SD 15,57). Low testosterone levels were found in 25% patients, and all had low or normal FSH and LH levels. There was a weak negative correlation between transferrin saturation and pituitary MRI T2 relaxation time in normal testosterone level group.

Conclusions: This study demonstrated high rate of patients who did not achieved puberty, but low rate of patient with low testosterone. There is a weak negative correlation between transferrin saturation and pituitary MRI T2 relaxation times."

"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."