Arifoel Hajat
Department Of Clinical Pathology, Faculty Of Medicine, Airlangga University, Surabaya

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The Effect of Long Storage of Whole Blood Components on the Level of 2,3 Diphosphoglycerate and Lactic Acid in the Blood Bank, Dr. Soetomo General Hospital, Surabaya, Indonesia Dwi Ajeng Roosanti; Betty Agustina Tambunan; Arifoel Hajat
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17485

Abstract

The purpose of this study was to analyze changes in levels of 2,3 DPG and lactic acid on WB storagetime. This research is an observational analytical with time series design was conducted at the ClinicalPathology Installation and Blood Bank Dr. Soetomo General Hospital Surabaya in the period July- September 2020. Levels of 2,3 DPG and lactic acid were measured in 16 bags of Whole Bloodcomponents on the day 1, day 5, day 10, day 20 and day 30. Statistical analysis was performed usingthe Friedman test. The results were statistically significant if p <0.05. The Friedman statistical testshowed that there were significant differences in levels of 2.3 DPG (p <0.001) and levels of lacticacid (p <0.001) during storage. The results showed that the level of 2,3 DPG in WB which was storeddecreased according to the duration of storage. The yield of lactic acid on stored WB increased withthe duration of storage. Therefore, saving WB is recommended to be given within <6 days to reducethe risk of acidosis. Further research is needed for other parameters that can affect the storage process.
PENGARUH CARA PENGOLAHAN BAWANG PUTIH (Allium sativum) TERHADAP EFEK ANTITROMBOTIK PADA MENCIT Prillye Deasy Octaviantie; Sri Purwaningsih; Arifoel Hajat
Jurnal Kedokteran Syiah Kuala Vol 17, No 3 (2017): Volume 17 Nomor 3 Desember 2017
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v17i3.9064

Abstract

ABSTRAK.Bawang putih (Allium sativum) telah terbukti memiliki banyak efek positif untuk kesehatan, antara lain antibakteri, antivirus, antijamur dan juga antioksidan. Selain itu, bawang putih juga memiliki beragam efek positif untuk sistem kardiovaskular, antara lain menyebabkan penurunan tekanan darah, mencegah terjadinya aterosklerosis, dan juga bersifat antitrombotik. Salah satu obat antitrombotik yang umum digunakan oleh masyarakat adalah aspirin. Aspirin bekerja dengan cara menghambat pembentukan tromboksan A2. Komponen antitrombotik yang dimiliki bawang putih adalah allisin, yang bekerja dengan berbagai cara, salah satunya dengan cara menghambat jalur pembentukan tromboksan A2 dan ADP. Penelitian ini bertujuan untuk mengetahui efektivitas bawang putih mentah, rebus, dan goreng bila dibandingkan dengan aspirin. Desain dari peneltian ini adalah eksperimental laboratoris dengan 8 (delapan) kelompok yang terdiri dari kelompok kontrol negative (CMC 1%), kontrol positif (Aspirin), kelompok bawang putih mentah dosis tinggi, bawang putih mentah dosis rendah, bawang putih rebus dosis tinggi, bawang putih rebus dosis rendah, bawang putih goring dosis tinggi, dan bawang putih goreng dosis rendah. Setiap kelompok terdiri dari 5 (lima) mencit yang akan menerima perlakuan dalam 1 (satu) bulan. Pada hari ke 30, waktu perdarahan dari setiap mencit akan diukur dengan cara memotong ekor mencit. Hasil dari penelitian ini menunjukkan bahwa kelompok kontrol positif (aspirin) memiliki waktu perdarahan terpanjang, disusul dengan kelompok bawang putih mentah dosis tinggi. Di peringkat ketiga ada kelompok kontrol negative (CMC 1%) dan kelompok bawang putih mentah dosis rendah yang memiliki waktu perdarahan yang sama. Sementara itu, kelompok bawang putih rebus dan goreng, baik pada dosis tinggi maupun rendah, menunjukkan waktu perdarahan yang lebih panjang dibandingkan dengan kelompok kontrol negative (CMC 1%).Pemanjangan waktu perdarahan ini kemungkinan disebabkan karena allisin pada bawang putih yang bersifat termolabil dan terdegradasi dengan peningkatan suhu.
Characteristic of Hemophilia A Patients in Initial Diagnosis in Dr. Soetomo General Hospital Surabaya Angela Dinaria Kemala Swary; Mia Ratwita Andarsini; Arifoel Hajat
Biomolecular and Health Science Journal Vol. 2 No. 1 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.927 KB) | DOI: 10.20473/bhsj.v2i1.12888

Abstract

Introduction: This research is conducted to describe the characteristic of Hemophilia A patients.Methods: Cross-sectional study conducted in 55 patients with Hemophilia A. The variables were age, bleeding episode, factor VIII level, and bleeding site. The data presented descriptively.Results: The largest group was 2-10 years old (52,73%). The most common bleeding episode occured in the patients was moderate level (60,0%). The most common patient’s factor VIII level was moderate level (52,7%). The patient’s bleeding most likely took place in muscle or known as hematoma (41,8%). While the less likely bleeding were intracranial and nose bleeding.Conclusion: 2-10 years old patient are the largest group because of hemophilia A mostly diagnosed in childhood, where children are actively moved so that the spontaneous bleeding or abnormal bleeding can be seen easily. Parents needs to be aware if there were abnormal or spontaneous bleeding which takes place in muscle or known as hematoma with moderate episode of bleeding which meant that the occurrence of spontaneous bleeding is periodically happened or in prolonged bleeding accompanied by minor trauma or invasive action.
Diagnostic Value of Determination Blast Cell Population Lineage Using WPC Scattergram Hematology Analyzer Nina Ratnasari; Arifoel Hajat; S. Ugroseno Yudho Bintoro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1585

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The diagnosis of hematology malignancies requires examination that includes morphology, immunophenotyping, and cytogenetics. Immunophenotyping is the most trusted examination in determining hematology malignancies lineage, but it is only available in large hospitals and the costs are relatively expensive, so the determination of lineage depends on bone marrow aspiration examination. Therefore it is necessary to have an easier and more reliable alternative to assist BMA morphology. White Precursor Cell (WPC) scattergram Sysmex XN-1000 has the capability to differentiate malignancy lineage. The purpose of this study was to determine the diagnostic value of determining lineage generated by WPC scattergram compared to the lineage from BMA examination. BMA blood samples were simultaneously examined by BMA morphology interpretation using microscope and WPC scattergram Sysmex XN-1000 examination. The hematology malignancies lineage resulting from BMA and WPC scattergram examination was then analyzed statistically to determine the suitability, sensitivity, and specificity. The results of determining the lineage of blast cell population based on WPC scattergram resulted in a suitability with a sensitivity of 93.75% and specificity of 94.74% for determining the hematological malignancy of myeloid lineage and 94.74% and 93.75% for lymphoid lineage, with a diagnostic accuracy of 94.91%. Based on this study it can be concluded that the WPC scattergram can determine the lineage of hematological malignancies with a suitability and high diagnostic value of lineage based on BMA morphology.
PATOGENESIS dan PEMERIKSAAN LABORATOPRIUM MIELOFIBROSIS PRIMER Johanis Johanis; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 2 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i2.1025

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Primary myelofibrosis (PMF) is a neoplastic hematologic disease, characterized by clonal hemapoietic stem cell and collagenaccumulation in bone marrow. PMF is not related with underlying myeloproliferative disorders or other diseases. The features of PMFshow marrow fibrosis, megakaryocytes and granulocytes proliferation, and extramedullary hemapoiesis. PMF is classified as BCR-ABLnegativemyeloproliferative disorders. Diagnosis of PMF is based on clinical symptoms of splenomegaly and myelopthisis; bone marrowbiopsy shows granulocytes/megakaryocytes hyperplasia, megakaryocytes dysmorphic and fibrosis; cytogenic testing for mutation ofJAK2V617F+, MPLW5I5L/K+ and BCR-ABL. The diagnostic criterion according to the 2008 WHO classification considers major andminor crieria. The primary purpose for treatment is to improve the quality of life by paliative tratment. The five year survival of PMFpatients is low.
CHRONIC MYELOGENEOUS LEUKEMIA TRANSFORMATION INTO ACUTE LYMPHOBLASTIC LEUKEMIA Endah Indriastuti; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1395

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Introduction : Chronic myelogeneous leukemia (CML) is a myeloproliferative neoplasm that can progress into various conditions. Transformation of CML into acute lymphoblastic leukemia (ALL) is a rare case. Case :  A 22-year-old male with history of CML since 2014 and positive BCR-ABL p210 in 2017 came with complaint of weakness. Physical examination showed hepatosplenomegaly. CBC results Hb  7.1 g/dL, WBC 290,620/μL, platelet 434,000/μL. Blood smear evaluation (BSE) suggested CML blastic crisis dd AML-M5. Patient’s condition got worse. CBC result showed  WBC 96,770/μL and  platelet 7,000/μL in 2 weeks later. BSE was dominated by mononuclear cells with scanty blue cytoplasm, no granules, no auer rods, loose chromatine and indistinct nucleoli, suggesting lymphoblasts with a proportion of 60%. Bone marrow aspiration (BMA) and immunophenotyping was done to confirm BSE. The BMA result was dominated by lymphoblast, consistent with ALL. The immunophenotyping result was CD10+, CD34+(0,99%), CD79a+, HLA-DR+, and CD20+.  Molecular examination showed positive RUNX1 and NRAS while negative FLT3, NPM1 and del(5q). Discussion : BCR-ABL gene can be found both in CML and ALL. CML transformation into ALL had been reported to be related with deletion of a transcription gene. Diagnosis of ALL can be established by BMA and immunophenotyping. CD34+ expression of lymphoblast in ALL can be varied, but in this case was minimal. Conclusion : Patient with history of CML showed an ALL picture based on BSE, BMA and immunophenotyping suggesting CML transformation into ALL although CD34+ expression was minimal.
Correlation between WDF, WNR, and RET Abnormal Scattergram Detected by Sysmex XN-1000 and Parasitemia of Malaria Patients in Merauke Hospital Merylin Ranoko; Aryati Aryati; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.1521

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Malaria remains a health problem in Indonesia. Microscopic examination with Giemsa staining is the gold standard for diagnosing malaria. The density of parasites correlates with the degree of severity and response to therapy of malaria. Malaria-causing plasmodium can be detected by Sysmex XN-1000 which is marked by abnormalities in the WDF, WNR and RET scattergram. This research aimed to determine the correlation of WDF, WNR and RET abnormal scattergram detected by Sysmex XN-1000 and the parasitemia index of malaria at the Merauke General Hospital. This was a cross-sectional study with observational approach conducted between November 2017 – February 2018 at the Merauke General Hospital. Positive malaria samples were stained with Giemsa, their parasitemia index was calculated, routine complete blood count using Sysmex XN-1000 was performed, and the scattergram abnormalities were then analyzed. There were 65 positive malaria samples as follows: P.falciparum (35%), P.vivax (60%), P.ovale (3.1%), and P.malariae (1.5%), but the species did not correlate with parasitemic index (p=0.691). Abnormalities of WDF and WNR scattergram were predominantly found than RET scattergram (80% vs. 27.7%). P.vivax predominantly caused abnormalities of the WDF and WNR scattergram in 36 of 39 samples (92.3%), whereas P.falciparum predominantly caused abnomalities of the RET scattergram in 14 of 23 samples (60.9%). There was 95% positivity of an abnormality in WDF/WNR/RET scattergram with a cut-off of > 5,0165.5/µL. There was correlation between WDF, WNR, RET scattergram detected by Sysmex XN-1000 and the parasitemia index.
Difference Expressions CD34 in Acute Myeloid Leukemia Cell Culture in the Administration of Cytarabine-Daunorubicine Dose Standards Muhammad Saiful Rahman; Paulus Budiono Notopuro; Suprapto Ma&#039;at; Made Putra Sedana; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1623

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The cure rate for patients with Acute Myeloid Leukemia (AML) is 20-75%. Standard-dose cytarabine + (SDAC)-daunorubicine gives a remission rate of ± 60%, and the case of relapse is frequently found. In-vivo CD34 expression is a reliable and straightforward test that must evaluate AML patients' response to predict the response of chemotherapy + induction phase accurately. Differences in in-vitro CD34 expression are expected to be able to predict chemosensitivity in AML patients. An experimental post-test-only control group study was conducted from May to December 2019, and 8 AML subjects were found. Peripheral Blood Mononuclear Cells (PBMC) were isolated from peripheral blood samples of patients with AML collected in EDTA tubes. The PBMC isolated from peripheral blood were divided into two groups, and each group contained 106 PBMC cells in culture media. The control group (without treatment) and the SDAC-daunorubicine group were 0 + incubated for 4 hours at 37 C with a 5% CO2 atmosphere. The expression of CD34 was measured using FACSCalibur™, while + CD34+ percentage was calculated with CellQuest™ software. The percentage of CD34 in the control, SDAC + DNR, showed a significant difference with p < 0.001. This study showed a significant difference between the control group and the group + administered with the standard dose of cytarabine-daunorubicine with p < 0.001. The average CD34 expression in the + SDAC-DNR treatment group was higher than in the control group. CD34 markers cannot be used as predictors of chemosensitivity in the administration of chemotherapy.
The difference of Reticulocyte Hemoglobin Equivalent Pre- and Post-Ultrafiltration Hemodialysis in Patients with Chronic Kidney Disease Ni Made Rindra Hermawathi; Arifoel Hajat; Yetti Hernaningsih; Widodo Widodo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1556

Abstract

Chronic Kidney Disease (CKD) is a condition characterized by kidney damage and a decrease of Glomerular Filtration Rate of less than 60 mL/ min/1.73 m2 in more than three months. Anemia is the most common complication in patients with CKD who regularly undergo hemodialysis. Reticulocyte Hemoglobin Equivalent (Ret-He) is a new parameter that can reflect the storage of iron for erythropoiesis. This study compared the Ret-He level pre and post-hemodialysis and evaluated the effect of ultrafiltration (UF) hemodialysis to Ret-He level in CKD patients. This research was an observational analytical study. Samples were 50 patients with CKD who underwent hemodialysis regularly in Dr. Soetomo Hospital Surabaya by consecutive sampling from August–September 2017. The measurement of the Ret-He level pre ultrafiltration hemodialysis was divided into UF < 2 L and UF ≥ 2 L. Both groups showed homogenous results. The group with UF < 2 L increased significantly from pre to post ultrafiltration (p=0.010). The group with UF ≥ 2 L was not increased considerably from 30.57±3.62 to 32.69±3.45 (p=0.413). Ret-He level in the group with UF < 2 L was 0.81±1.10, significantly higher than the group with UF  ≥ 2 L  0.12±0.83 (p=0.017). The difference of Ret-He level pre and post ultrafiltration was significant in UF < 2 L. There was a significant increase of the Ret-He level in hemodialysis with  UF < 2 L compared to UF ≥ 2 L. The measurement of Ret-He should be performed before hemodialysis due to an increase in Ret-He after ultrafiltration hemodialysis.
TEG's Utility to Detect Hypercoagulability in Adult Patients at Post-Cardiac Surgery Using Cardiopulmonary Bypass in ICU Hildegardis Dyna Dumilah; Hartono Kahar; Arifoel Hajat; Philia Setiawan; Heroe Soebroto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1615

Abstract

The use of Cardiopulmonary Bypass (CPB) in adult patients of cardiac surgery disrupts the coagulation system. The mostcommon complication of the coagulation system is bleeding; however, that does not rule out the possibility of a dangeroushypercoagulation condition. A quick and precise coagulation test can provide clues for clinicians to predict futurehemostatic disorders or determine interventional therapy. aPTT and PT are standard laboratory tests, which are limited todetect a deficiency of coagulation factors. Thromboelastography (TEG) test (R time, K time, α angle, MA, and LY30) providesan overview of the entire coagulation and fibrinolysis process with faster results. A 2.7 mL citrate blood sample was takenand tested in a TEG®5000 device, then centrifuged. The plasma was then tested for aPTT and PT using the Sysmex CS-2100idevice. Bleeding volume was measured from chest drain 1-2 hours in the ICU after chest closure in the operating room.Bleeding criteria were as follows: > 1.5 mL/kg/hour for 6 hours consecutively in 24 hours or > 100 mL/hour. The resultsshowed 30 patients with no clinically significant bleeding. A significant correlation was found between PT and bleedingvolume at IV hour (p=0.008, r= 0.472). There was no correlation between aPTT and TEG (R time, K time, α angle, MA, andLY30) with the bleeding volume at I, II, III, and IV hours. There was a hypercoagulation indication of the TEG test of 56.7%,which showed clinical importance for the patient. PT can be used to analyze changes in bleeding volume at IV hour and TEGis more superior to detect hypercoagulability of adult patients after cardiac surgery with CPB.