The detection of AL, HFLC, IG, and IPF by Sysmex XE-5000 hematology analyzers can help to differentiate between common causes of febrile illnesses with thrombocytopenia in dengue endemic areas. We recommend further investigating the discriminatory value of these parameters in clinical practice.

Background: Increased Neutrophil-to-Lymphocyte Ratio (NLR) is an independent risk factor for mortality in Covid-19 patients and is considered as an early warning sign of Covid-19 severity. This study aimed to observe the differences in NLR at admission between patients with mild, moderate, and severe symptoms of Covid-19 treated in a referral hospital in Banda Aceh, Indonesia.Methods:  A total of 114 patients with Covid-19 admitted to a referral hospital in Banda Aceh, Indonesia, during March–September 2020 were included in this study. Demographic information and baseline laboratory data, including the NLR, were collected. Descriptive and inferential statistics were used to analyze the data. Results: The median NLR at admission was higher among patients with moderate to severe symptoms than those with mild symptoms [6.54 (2.80–97.00, IQR 4.81–9.44) vs 2.27 (0.79–5.07, IQR 1.43-2.98), p <0.001]. Covid-19 patients who died had a higher NLR than those who survived [10.88 (4.17–47.50, IQR 7.00–15.17) vs 6.15 (2.80–97.00, IQR 4.63–8.50), p 0.02]. Patients with moderate-severe symptoms had an initial NLR of 4.63–8.50 and decreased to 2.75–5.43 at the end of the treatment had a greater chance of survival. There was an increased probability of death in patients with moderate-severe symptoms whose initial NLR was 7.00–15.17, which was then elevated to 14.33–23.25.Conclusion: Different NLR at admission is seen among Covid-19 patients with mild and moderate-severe symptoms, leading to significantly different outcomes. The NLR can be used as a simple parameter to determine the severity of the disease and predict the outcome of Covid-19 patients.

Introduction: We aim to describe the performance of combined IgM and IgG point-of-care antibody test (POC-Ab) (Wondfo®) compared to real-time reverse transcriptase (rRT-PCR) (Allplex™ 2019-nCoV Assay) in detecting coronavirus disease 2019 (COVID-19). Methodology: We compared POC-Ab with rRT-PCR results among patients in a tertiary hospital from January to March 2020 in Bandung, Indonesia. We selected presumptive COVID-19 patients with positive rRT-PCR consecutively and 20 patients with negative rRT-PCR results were selected randomly from the same group of patients as controls. We described the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) with corresponding 95% confidence interval using serum and capillary blood samples. We also tested POC-Ab using non-COVID-19 (confirmed dengue and typhoid) patients’ sera. Results: Twenty-seven patients with positive rRT-PCR result and 20 negative controls were included (68.1% males, mean age 46 (SD: 15.4)). Using the serum, the sensitivity of the POC-Ab was 63.0% (42.4-80.6), specificity was 95.0% (75.1-99.9), PPV was 94.4% (72.7-99.8), NPV was 65.5% (45.7-82.1). A subset of 20 patients was tested using a capillary blood sample. The accuracy of the capillary blood sample is lower compared to serum (50.0% vs. 78.7%). None of the non-COVID-19 sera tested were reactive. Conclusions: POC-Ab for COVID-19 has a high specificity with no false-positive result in non-COVID-19 sera. Therefore, it can be used to guide diagnostic among symptomatic patients in resource limited settings. Given its low sensitivity, patients with high suspicion of COVID-19 but non-reactive result should be prioritized for rRT-PCR testing.

Tuberculosis (TB) is still a major health problem, especially in the developing countries. The combination of antituberculosis drugs are generally recommended for the treatment of tuberculosis. Van Crevel study in Jakarta found that most (70%) of patients with pulmonary TB who received combined antituberculosis drugs with standard (450 mg) dose rifampicin had very low plasma rifampicin level. Based on this results, TB Research and Clinical Trial Centre Bandung & University Medical Centre Nijmegen, The Netherlands conduct the study which compared clinical outcome between standard and high (600 mg) dose of rifampicin. Most of antituberculosis drugs currently available are very low in causing acute and chronic toxicities, however we must keep aware of side effect during the treatment. The most serious adverse effect of several drugs is liver damage (drug induced hepatitis) and potentially fatal hepatitis. To detect liver demage earlier aspartate aminotransferase( AST) and alanine aminotransferase (ALT) serum level were examined during antituberculosis treatment. The aim of this study was to determine AST and ALT serum level at intensif phase of antituberculosis treatment with standard and high dose rifampicin. The study had been done from August 2003 to September 2004 at Dr Hasan Sadikin Hospital and Balai Pengobatan Penyakit Paruparu, Bandung. The subjects were divided randomly into 2 groups. The first group consisted of patients with category I antituberculosis drugs with standard dose rifampicin and the second group patients also category I with high dose rifampicin. Aspartate aminotransferase and ALT serum level were examined at week 0 (before treatment), 2nd, 4th, and 8th. This was randomized clinical trial with paralel design study. Statistical analysis used paired t test to compare the dose effect of rifampicin to AST and ALT serum level changes, t independent test to compared mean difference of AST and ALT serum level changes which is projected by profile analysis. p value < 5%.. The prevalence of the hepatotoxicity were 17.39% of standard dose and 18.17% of high dose rifampicin. The hepatotoxicity were mild and moderate level,and it was already present at 2 weeks of therapy. There were no significant difference of AST and ALT serum level beetween those two groups. Conclusion: In this study antituberculosis drugs with high dose rifampicin were safe for TB patients.

Thromboembolic events are potentially life-threatening clinical complications found in β-thalassemia patients. The pathogenesis of the hypercoagulable state in β-thalassemia patients results from the degradation of excess α-globin chains in red blood cells, leading to intracellular labile iron accumulation, oxidative stress, and more rigid, deformed, and eventually prematurely damaged red blood cells. This process is associated with the loss of the normal asymmetrical distribution of membrane phosphatidylserine and its exposure to the outer surface of the blood cell membrane resulting in the formation of tenase complexes, prothrombinase, and thrombin complexes. Increased thrombins lead to platelet activation and platelet-derived microparticles synthesis, which in turn contributes to thrombus formation. This study aimed to determine the increase in the platelet-derived microparticle count by direct labeling of CD62P and CD41 monoclonal antibodies in β-thalassemia patients when compared with normal subjects. This was a cross-sectional analytical quantitative study conducted in Dr.

The thalassemia screening program in Indonesia mostly conducted sporadically. Ideal prospective screening is still limited. This study aimed to compare thalassemia screening methods using the extended family approach with and without a history of severe thalassemia and the feasibility of implementing extended family screening method. A case control study was conducted in Dr. Hasan Sadikin General Hospital Bandung with 3 generations of extended families. Data were collected from 150 subjects of 8 extended families with severe thalassemia as an index case entry and 151 subjects of 12 families with no history of thalassemia. All subjects were examined for Hb, MCV, MCH, and peripheral blood smear (PBS) as initial laboratory examinations. Subjects with MCV < 80 fL, MCH < 27 pg, and suggestive findings on PBS continued hemoglobin analysis. Carrier status was determined by definition. All subjects consented to undergo screening and voluntarily participated. The proportion of thalassemia carriers and the participation rate between the 2 groups were compared. Sixty-four of 150 (42.7%) and 16 of 151 (10.6%) carriers were identified in both the case and control group (p < 0.001). The participation rate was 42–88 vs. 23–100% (p = 0.244). The mean age was 31.9 ± 21.2 vs. 31.1 ± 20.8 years (p = 0.782). The median family size was 28.5 vs. 20 subjects per family (p = 0.245). The types of identified thalassemia carrier in both groups consisted of β-thalassemia, β-thalassemia/HbE, suspected α-thalassemia, and β-thalassemia Hb variant. All carriers continued the counseling process. The extended family method seems feasible to be implemented for thalassemia screening in West Java, Indonesia.

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D-Dimer parameter is the most usefull laboratory assay to detect the present of activated coagulation. The D-Dimer fragment directlyindicate the fibrinolitic proccess whereas the increasing mark of D-Dimer is the most hemostatic parameter that was used to detectthe early stage of Disseminated Intravascular Coagulation (DIC) and has a correlation with the patient prognosis. D-Dimer assay byimmunoturbidimetric method was used to detect antigen-antibody reaction automatically and it can detect D-Dimer concentration lessthan 0.5 μg/mL. The immunoturbidimetric method has a good correlation with the ELISA method, but the proccess is complicated, ishigh costed, and need the competence of practical human resource. D-Dimer assay with immunofiltration method has the same principleas immunoturbidimetric method, but it's work more simpler, low cost and does not need the competence of practical human resource.The aim of this study is to compare the D-Dimer assay concentration between immunofltration and immunoturbidimetric method. Therewere 30 plasma samples assayed with these two methods (immunoturbidimetric and immunofiltration), and then compared betweenthem. The samples were collected between November until December 2008 at Rumah Sakit dr. Hasan Sadikin Bandung. The validity ofD-Dimer using immunofiltration method showed sensitivity 74%, specificity 95%, predictive value of negative test (PV-) 22%, predictivevalue of positive test (PV+) 95% with likelihood ratio 5.2. The conclusion of this study so far that the immunofiltration method has agood validity for diagnosing. D-Dimer work rapidly with low cost laboratory assay than the immunoturbidimetric method.