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All Journal Jurnal Kedokteran Syiah Kuala Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indian Journal of Forensic Medicine & Toxicology
Arifoel Hajat
Department Of Clinical Pathology, Faculty Of Medicine, Airlangga University, Surabaya
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)

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LEUKOCYTE INTERFERENCE ON HEMOGLOBIN EXAMINATION IN HEMATOLOGY MALIGNANCY Trinil Sulamit; Fery H. Soedewo; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 3 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i3.1193

Abstract

Pasien keganasan hematologi sering menunjukkan gejala anemia dengan hasil laboratorium leukositosis. Tolok ukur penentu anemiasalah satunya hemoglobin, namun pemeriksaannya terganggu oleh jumlah leukosit tinggi yang menyebabkan hemoglobin tinggi palsu.Penelitian ini bertujuan mencari berapa jumlah leukosit minimal penyebab hemoglobin tinggi palsu pada keganasan hematologi. Sampeldarah EDTA pasien keganasan hematologi yang memeriksakan darah rutin di Laboratorium Patologi Klinik RSUD Dr. Soetomo bulanApril–Mei 2016. Penelitian analisis observasional dengan membandingkan hemoglobin tanpa pemusingan dengan hemoglobin setelahpemusingan serta dibuang buffy coat-nya. Terdapat 93 sampel dengan leukemia 43%, limfoma 16,12% dan terduga leukemia 38%.Rerata selisih hemoglobin yaitu 0,06±0,089; 0,025±0,05; 0,1±0,081; 0,15±0,07; 0,81±0,63; 0,94±1,13; 1,13±0,718; 1,6±0,818 g/dL pada peningkatan kelompok jumlah leukosit secara berurutan >11.000-20.000 sel/μL, >20.000-30.000 sel/μL, >30.000-40.000sel/μL, >40.000-50.000 sel/μL, >50.000-100.000 sel/μL, >100.000-200.000 sel/μL, >200.000-300.000 sel/μL, >400.000 sel/μL.Kenasaban rerata selisih hemoglobin dengan kelompok jumlah leukosit menunjukkan makin tinggi leukosit maka makin besar rerataselisih hemoglobin dengan kenasaban positif sedang. Semakin tinggi jumlah leukosit makin tinggi persentase hemoglobin tinggi palsudan rerata selisih hemoglobin makin besar. Leukosit minimal penyebab hemoglobin tinggi palsu pada keganasan hematologi yaitu 56.745sel/μL yang memiliki kepekaan 89,4% dan kekhasan 100%, dengan koefisien  0,592.
CORRELATIONS BETWEEN MEAN PLATELET VOLUME AND IMMATURE PLATELET FRACTION TO HEMOGLOBIN A1C IN PATIENTS WITH TYPE 2 DIABETES MELLITUS Dian W Astuti; Sony Wibisono; Arifoel Hajat; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1148

Abstract

Pasien diabetes melitus tipe 2 berkebahayaan mengalami komplikasi makro dan mikrovaskuler, yang dipengaruhi oleh kendaliglikemik. Reaktivitas trombosit berperan pada timbulnya komplikasi ini, terutama komplikasi kardiovaskuler. Tujuan penelitian iniadalah membandingkan MPV dan IPF di kendali glikemik baik dan buruk dan menentukan adanya kenasaban MPV dan IPF terhadapHbA1c. Penelitian bersifat analitik observasional dengan rancang bangun potong lintang. Sampel darah EDTA dari 43 orang pasienDM tipe 2, dikumpulkan selama Januari-Februari 2016. HbA1c diperiksa dengan Dimension RxL, sedangkan MPV dan IPF diperiksadengan Sysmex XN-1000. Rerata nilai MPV 10,36±0,84 fL, rerata nilai IPF 4,22±2,29%. Uji perbedaan nilai MPV menurut kendaliglikemik didapatkan p=0,494, uji perbedaan IPF didapatkan p=0,462. Uji kenasaban Pearson antara IPF dan MPV didapatkanr=0,877 (p<0,0001), MPV dan HbA1c didapatkan r=0,018 (p=0,907), IPF dan HbA1c didapatkan r=0,128 (p=0,414). Penelitian inimenunjukkan rerata MPV berada dalam rentang normal, sedangkan rerata IPF meningkat, namun tak terdapat perbedaan bermaknanilai MPV dan IPF di kendali glikemik baik dan buruk. MPV dan IPF pada penelitian ini tak bernasab dengan HbA1c.
Hairy Cell Leukemia (Morphologic and Immunophenotypic Profile) Anindita Novia Damayanti; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1712

Abstract

Hairy Cell Leukemia (HCL) is a lymphoproliferative B cell abnormality dominated by mature lymphocytes with cytoplasmic projections and often misunderstood as Chronic Lymphocytic Leukemia (CLL). Misdiagnosis can be caused by errors in the preparation of peripheral Blood Smear Evaluation (BSE). Immunophenotyping is an option to differentiate HCL from CLL. A 56-year-old female presented with complaints of weakness. Physical examination showed conjunctival anemia 3 3 and hepatosplenomegaly. Hematological test results were as follows: Hb 7.4 g/dL; WBC 131.24x10 /uL; and Plt 61x10 /uL. BSE And Bone Marrow Aspiration (BMA) showed predominantly mature lymphocytes with cytoplasmic projections and suspected CLL with HCL as the differential diagnosis. Immunophenotyping with peripheral blood samples showed CD19+, CD20+, CD79a+, HLA-DR+, CD5-, and CD7- suggesting an increasing mature lymphocytes population (74.16%) that expressed B lymphoid lineage. White Precursor Cell (WPC) channel test showed an abnormal lymphocytes population. The differential diagnosis of patients with dominant mature lymphocytes BSE with cytoplasmic projections was CLL and HCL. Immunophenotyping of CLL showed positive results on B cell markers (CD19, CD20, CD79a, and HLA-DR) with aberrant CD5. However, in such an HCL case like this, there were strongly positive results on B cell markers but the absence of aberrant CD5. This study was supported by the presence of abnormal lymphocytes population in the WPC test. The diagnosis of HCL in this patient was based on interpretation of BSE and immunophenotyping, supported by the WPC test.
Determining Acute Leukemia Lineage Using Mie Map Red Blood Cell Nelly Zuroidah; Arifoel Hajat; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1747

Abstract

The determination of myeloid and lymphoid lineage is essential for the diagnosis and therapy of acute leukemia. Immunophenotyping is the gold standard to determine the lineage of acute leukemia, but it is still constrained and relatively expensive. Mie Map RBC in the ADVIA 2120i is a parameter that can give additional information about myeloid and lymphoid lineage but has never been studied before. It is expected that Mie Map RBC can be used to differentiate the lineage of acute myeloid and lymphoid leukemia if immunophenotyping is not present. This study aimed to analyze the diagnostic value of Mie Map RBC with ADVIA 2120i towards immunophenotyping in determining myeloid and lymphoid lineage in acute leukemia. Child and adult patients diagnosed with acute leukemia (n=30) that had peripheral blood smear and bone marrow aspiration with blasts > 20% were examined using ADVIA 2120i. The Mie Map RBC lineage results were compared to the lineage of immunophenotyping. The sensitivity and specificity of the Mie Map RBC myeloid series are respectively 60.00%, 93.33%. The sensitivity and specificity of the Mie Map RBC lymphoid series are respectively 93.33% and 60.00%. The diagnostic accuracy value of Mie Map RBC is 76.67%. The determination of acute leukemia myeloid series lineage has high specificity. If there is no population outside the matrix of Mie Map RBC, it highly suggests myeloid series. On the other hand, the determination of acute leukemia lymphoid series lineage has a relatively low specificity meaning that the population outside the matrix of Mie Map RBC does not always suggest a lymphoid lineage
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

Abstract

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.
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.
The Differences Levels of RANTES and PF4 Based on the Storage of Platelet Concentrate Ni Made Rindra Hermawathi; Betty Agustina Tambunan; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1577

Abstract

Blood component transfusion is often used as the primary therapy as it is still considered safe. Platelet Concentrate (PC) transfusion plays a critical role in preventing bleeding in patients with severe thrombocytopenia. Allergic reactions are the most frequent transfusion reactions after PC administration. Regulated on Activation Normal T-Cell Expressed and Secreted (RANTES) and Platelet Factor 4 (PF4) cytokines released by platelets during PC storage are responsible for allergic reactions after transfusion. The purpose of this study was to analyze changes in RANTES and PF4 levels during PC storage. This study was an observational analytical research with a time series design carried out at the Clinical Pathology Laboratory and Blood Bank of the Dr. Soetomo Hospital, Surabaya, from June to July 2019. RANTES and PF4 levels in 27 bags derived from Platelet Rich Plasma (PRP) on storage for day 1, day 3, and day five were measured using the ELISA sandwich method. Subject same variant test or Friedman test was used for statistical analysis. The results showed no significant differences in RANTES and PF4 levels based on the storage duration of PCs on days 1, 3, and 5, with p=0.717, and p=0.614, respectively. There was no difference in the storage of PCs from day 1 to day five, and there was no effect on allergic reactions after PC transfusion.
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

Abstract

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.
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 most common complication of the coagulation system is bleeding; however, that does not rule out the possibility of a dangerous hypercoagulation condition. A quick and precise coagulation test can provide clues for clinicians to predict future hemostatic disorders or determine interventional therapy. aPTT and PT are standard laboratory tests, which are limited to detect a deficiency of coagulation factors. Thromboelastography (TEG) test (R time, K time, α angle, MA, and LY30) provides an overview of the entire coagulation and fibrinolysis process with faster results. A 2.7 mL citrate blood sample was taken and tested in a TEG®5000 device, then centrifuged. The plasma was then tested for aPTT and PT using the Sysmex CS-2100i device. 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 results showed 30 patients with no clinically significant bleeding. A significant correlation was found between PT and bleeding volume at IV hour (p=0.008, r= 0.472). There was no correlation between aPTT and TEG (R time, K time, α angle, MA, and LY30) 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 TEG is more superior to detect hypercoagulability of adult patients after cardiac surgery with CPB.  
Pancytopenia and Progressive Splenomegaly in Patient with Disseminated Histoplasmosis Paulus Budiono Notopuro; Arifoel Hajat; Made Putra Sedana
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.v27i2.1621

Abstract

Disseminated histoplasmosis is a severe manifestation of fungal infection caused by Histoplasma capsulatum. It usually occurs in a patient with an immunodeficiency state. With the increase of HIV infection and the use of immunosuppressant drugs lately, its prevalence also increases. A case of 43 years old female with prolonged fever, pancytopenia, and massive progressive splenomegaly. The diagnosis of disseminated histoplasmosis and the secondary hemophagocytic syndrome was made based on bone marrow examination that showed increased hemophagocytic processes and multipleintracytoplasmic H.capsulatum. She had been treated with Itraconazole 200 mg for three months. In the first month's evaluation, her complete blood count improved without any transfusions, and the size of her spleen size decreased. She had been fully recovered after the completion of 3-month treatment.
Co-Authors Angela Dinaria Kemala Swary Anindita Novia Damayanti Aryati Aryati Aryati Aryati betty Agustina Tambunan, betty Agustina Dian W Astuti Dwi Ajeng Roosanti Endah Indriastuti Endah Indriastuti Ersa Bayung Maulidan Fery H. Soedewo Hartono Kahar, Hartono Heroe Soebroto Hildegardis Dyna Dumilah Johanis Johanis Made Putra Sedana Made Putra Sedana Merylin Ranoko Mia Ratwita Andarsini Muhammad Saiful Rahman Nelly Zuroidah Ni Made Rindra Hermawathi Ni Made Rindra Hermawathi Nina Ratnasari Paulus Budiono Notopuro Philia Setiawan Prillye Deasy Octaviantie Puspitasari, Yessy Semedi, Bambang Pujo Sidarti Soehita Siti Nurul Hapsari Sony Wibisono Sri Purwaningsih Suprapto Ma&#039;at Suprapto Ma'at Trinil Sulamit Widodo Widodo Yetti Hernaningsih Yudho, S. Ugroseno