Among the inherited blood disorders in Southeast Asia, thalassemia is the most prevalent. Thalassemias are pathologies that derive from genetic defects of the globin genes. Thalassemia is also considered a health burden among the world's population. Thalassemia cannot be cured, but there is a method to prevent the occurrence of thalassemia by early detection with screening. The aim is to identify the suspected unrecognised diseases in a population that seems healthy and asymptomatic using tests, examinations, or other procedures that can be applied quickly and easily to the target population. Research on thalassemia has been done extensively, such as testing the accuracy of β-thalassemia data in Thailand using the Bayesian Network and Multinomial Logistic Regression. In this study, we will compare the performance of the classification of thalassemia data by Fuzzy C-Means, Fuzzy Kernel C-Means, and Fuzzy Kernel Robust C-Means. The author uses thalassemia data from Indonesia, acquired from Harapan Kita Children and Womens's Hospital, Jakarta, that consists of 82 thalassemia samples from the patients of thalassemia and 68 nonthalassemia samples with 11 features. In total, there are 150 data patients used in this paper. The results show the accuracy of the classification. The accuracy of FCM is 100% when training data is 90%, FRCM is 100% when training data is 90%, and FKRCM, which is the modified Fuzzy, 100% when we use the = 0.0001 and 80% & 90% training data. This result denote that Fuzzy C-Means, Fuzzy Robust C-Means, and Fuzzy Kernel Robust C-Means perfectly classify thalassemia data from Indonesia.
Thalassemia is a blood disorder that occurred in Southeast Asia. Thalassemia cannot be cured, but early detected thalassemia with screening process is the best way to prevent thalassemia disease. If early detection is done, patients can get the right treatment. It helps them increase their life expectancy and reduce the risk of thalassemia to the next generation. In this paper, we use thalassemia data and propose a random forest method to classify thalassemia disease well and accurately. The result concludes that the random forest algorithm can give the best accuracy, precision and recall which is 100 percent by using multiple five in range of 70 to 85 percent as the training data.
Background Thalassemia is a major public health problem inIndonesia. Cardiac diseases remain as the main cause of death inthese patients due to iron overload. Although the T2* magneticresonance imaging has been considered as the gold standard forassessing cardiac iron overload but it has limited availability.The tissue doppler imaging (TDI) echocardiography, a fairly newand easy method that is suggested, can detect early abnormalmyocardial iron overload.Objective To assess myocardial systolic and diastolic functionof thalassemic patients using TDI and examine their correlationwith serum ferritin level.Methods A crosssectional study was conducted from January toMarch 2011 at the Harapan Kita Women and Children Hospital.We performed clinical examination, serum ferritin level, as wellas conventional and tissue doppler echocardiography on allsubjects.Results We included 34 regularlytranfused patients, of which17 were boys. The mean age of the subjects was 11.6 (SD 4.7years, range 2.6 20 years). Mean pulse rate and blood pressurewere within normal range. Hemoglobin level at inclusion rangedfrom 5.8 to 6 g/dL. Almost all patients did not receive regularchelation therapy. Median serum ferritin level was 6275 ng/mL(range 2151 - 17,646 ng/mL). Conventional echocardiographyshowed normal systolic function, but some diastolic dysfunctionswere found including E wave abnormalites in 4 patients, A waveabnormalites in 3, and E/A ratio abnormalites found in 3. TheTDI showed decreased systolic function (Sa wave abnormality) in9 patients and diastolic dysfunctions (Ea wave abnormality in 11patients and Aa wave abnormaly in 2). No abnormality was foundin Ea/Aa and ElEa ratios. There was a weak negative correlationbetween ferritin level and Sa wave and Ea wave respectively anda moderately negative correlation between ferritin level and Ea/Aa ratio. There was no correlation between serum ferritin andAa wave or ElEa ratio.Conclusion TDI identifies a greater number of patients Mthsystolic and diastolic myocardial dysfunction than was revealedby conventional echocardiography. There was a weak negativecorrelation between serum ferritin to Sa wave and Ea wave, and amoderately negative correlation between ferritin and Ea/Aa ratio.There was no correlation between serum ferritin and Aa wave orElEa ratio. [paediatr Indones. 2012;52:187,93].
Background Patients with b-thalassemia major, long-term trans-fusion, extravasal hemolytic, and increased intestinal absorptionof iron result in systemic iron overload, which may accumulate inmyocardium causing cardiac dysfunctions. Congestive heart fail-ure usually develops in adolescence or early adult years, and pa-tient usually dies within 1 year after the onset of symptoms. There-fore, it is important to detect early signs of cardiac dysfunction inpatient with thalassemia.Objective This study aimed to assess the correlation betweenferritin level and cardiac dysfunction in patients with thalassemia.Methods A cross sectional study was conducted on 62 b-thalas-semic patients (34 males and 28 females) with age ranging from3.5 to 23 years. They received 3,150 – 94,985 mL of blood; withthe serum ferritin level of 812.2 – 12,175 ng/mL. Each patient un-derwent laboratory examinations and clinical cardiac evaluationwith ECG and echocardiography.Results Cumulative blood transfusions correlated well with theserum ferritin values (p=0.001). The serum ferritin level did notshow correlation with deferoxamine (DFO) treatment. ECG exami-nation revealed 5 patients (8.1%) with dysrhythmia, LVH, and heartblock grade II and I. Echocardiography examination showed 18patients (29%) with systolic or diastolic dysfunction. There was nocorrelation between the serum ferritin level and cardiac dysfunc-tions (p=0.640). The serum ferritin prediction value against car-diac dysfunctions could not be established.Conclusion There was no correlation between serum ferritin lev-els with cardiac dysfunctions. In detecting cardiac dysfunctions inthalassemic patients, echocardiography was more sensitive thanECG
Latar belakang. Thalassemia adalah salah satu penyakit kelainan darah yang cukup banyak diderita oleh anak-anak di Indonesia. Dengan penanganan thalassemia yang baik maka angka harapan hidup anak thalassemia meningkat. Transfusi darah terus-menerus menimbulkan masalah timbunan besi dalam tubuh, dan paling sering menyebabkan pubertas terlambat pada anak thalassemia. Tujuan. Melihat angka kejadian keterlambatan pubertas pada anak thalassemia, kadar serum ferritin dan hubungannya dengan terapi kelasi besi yang didapat di RSAB Harapan Kita Jakarta. Metode. Penelitian dilakukan secara deskriptif pada 14 anak thalassemia yang dirawat di Rumah Sakit Anak Bunda (RSAB) Harapan Kita dari 1 Januari 2008 -31 Maret 2011. Data diambil dari rekam medis dan dianalisis dengan SPSS 17.0Hasil. Pasien thalassemia anak dan berada dalam usia pubertas adalah 28,6% laki-laki dan 71,4% perempuan. Anak yang mengalami keterlambatan pubertas 5 anak (35,7%), yaitu 2 anak (14,3%) perempuan dan 3 anak (21,4%) laki-laki. Kadar serum ferritin di atas 10000 ng/mL dijumpai pada 2 anak (14,3%) dan 13 anak (92,9%) memiliki status gizi kurang. Loss to follow up 4 anak (28,6%) dan yang meninggal 2 anak (14,3%). Rata-rata jumlah transfusi 108,6±42,3 cc/kgBB/tahun dan rata-rata kadar serum ferritin adalah 7130,1±3621,4 ng/mL. Kesimpulan. Angka kejadian pubertas terlambat pada thalassemia di RSAB Harapan Kita Jakarta adalah 35,7%. Keterlambatan pubertas itu dapat karena deposit besi yang tinggi dalam tubuh dan terapi besi yang tidak adekuat. Selain itu pubertas juga dipengaruhi oleh status gizi dari anak tersebut. Anak thalassemia di RSAB Harapan Kita 92,9% memiliki status gizi yang kurang. Untuk itu deteksi dini untuk melihat tanda-tanda pubertas pada anak thalassemia sangat diperlukan untuk anak perempuan yang sudah menginjak usia 8 tahun dan anak laki-laki 9 tahun sehingga penanganan dari keterlambatan pubertas dapat dimulai sejak awal. Dengan terapi kelasi besi yang adekuat diharapkan anak thalassemia mengalami perkembangan pubertas yang sama dengan anak normal. Sari Pediatri 2012;14(3):162-6.
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