Background. Acquired immunodeficiency syndrome (AIDS) is caused by the Human immunodeficiency virus (HIV) infection and characterized by a progressive decrease in the immune system function which eventually leads to the development of opportunistic infections and other complications. In order to monitor the disease progression the CD4 examination and additional Complete Blood Count (CBC) were commonly used.Objectives. To determine the correlation of total lymphocyte count, hemoglobin level, lymphocyte/leukocyte ratio (LLR) and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with HIV infection.Methods. This a retrospective cross-sectional analytic study conducted from July to August 2017. The total lymphocyte count, hemoglobin level, lymphocyte/leukocyte ratio (LLR) and lymphocyte/neutrophil ratio (LNR) and CD4 level were measured in the study. The data normality and the correlation were analyzed using the Kolmogorov-Smirnov test and the Pearson Correlation test, respectively, performed in SPSS version 14. The p-value less than 0.05 was considered significant for the results.Results. A total of 60 samples conducted CD4 and complete blood counts (CBC) examinations during the period July-August 2017. The mean CD4 levels were 341.73 ± 243.48 cells/µL, the total leukocyte count was 6.98 ± 2.93 x 103/µL, the total lymphocyte count was 2.09 ± 0.87 x 103/µL, hemoglobin level 13.38 ± 2.09 g/dL, lymphocyte/leukocyte ratio (LLR) 0.31 ± 0.11, lymphocyte/neutrophil ratio (LNR) 0.67 ± 0.40. Statistical analysis showed that data is normally distributed. Pearson correlation analysis showed that there was a significant relationship between CD4 levels with total lymphocytes counts, hemoglobin levels, RLL, RLN with correlation coefficients of 0.571 (p = 0.000), 0.324 (p = 0.012), 0.509 (p = 0.000), 0.463 (p = 0.006), respectively. There was no significant correlation between CD4 levels and total leukocytes with a correlation coefficient of 0.171 (p = 0.19).Conclusion. There is a positive correlation between CD4 levels and total lymphocytes, hemoglobin levels, RLL and RLN in patients with HIV at Sanglah Hospital.

Background: Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell diseases, accounting for  < 5% of all hematologic malignancies in children.  MDS is characterized by cytopenia, dysplasia in one or more of the major myeloid lineages, ineffective hematopoiesis, and recurrent genetic abnormalities. Approximately 30% of patients with MDS show progression to AML within a few months up to several years. This is an MDS case report in children who have undergone Acute Myeloid Leukaemia transformation with Myelodysplasia-Related Changes (AML-MRC).Case Report: A 16-year-old boy came to the Emergency Department of Sanglah General Hospital with a complaint of pain and swelling in both knees and joints since last month. Fatigue and fever happened a week before admission. Previously, he had been hospitalized twice with the same symptoms. Physical examination revealed pale conjunctiva with pancytopenia in the laboratory result. A blood smear showed normochromic normocytic anemia, neutropenia, and thrombocytopenia. Bone marrow aspiration morphology showed hypercellularity with blast presentation > 10% and multilineage dysplasia > 50% supporting MDS diagnosed transformation to Acute Myeloid Leukaemia with Myelodysplasia-Related Changes (AML-MRC). Leukemia phenotyping showed positive results on CD 33, CD 36 and HLA-DR presenting Monocytic Lineage.                                                                                                             Conclusion: High degree dysplasia and blast percentage in blood and bone marrow increase tendency to transform into acute myeloid leukemia (AML). The diagnose of MDS requires analysis of blood and bone marrow morphology and cytogenetic analysis as a recommendation by WHO classification.

Background: Anemia in patients with diabetes mellitus (DM) is often associated with anemia of chronic disease caused by inflammation or iron metabolism disorders. Hepcidin is known to function in initiating the internalization and degradation of ferroportin. It can inhibit the release of iron from cells where an increase in hepcidin levels will reduce iron absorption in the intestine, resulting in a decrease in serum iron levels. This study aims to determine the relationship between serum hepcidin levels and anemia in patients with Type-2 Diabetes Mellitus (T2DM). Methods: This cross-sectional study was conducted on 77 consecutive T2DM patients who met the inclusion and exclusion criteria and received health services at Sanglah Hospital, Bali, Indonesia, during the study period. The variables assessed in this study included T2DM status (controlled and uncontrolled), anemia, hemoglobin, HbA1c, erythrocyte sedimentation rate, and hepcidin. Data were analyzed with SPSS version 20 for Mac. Results: There was no significant difference in age, sex, disease duration, SGOT, SGPT, leukocytes, platelets, and ESR between controlled and uncontrolled T2DM groups (p>0.05). However, there was a significant difference in eGFR and hemoglobin levels between controlled and uncontrolled T2DM groups (p<0.05). Mann-Whitney U test found a significant difference in hepcidin levels between controlled and uncontrolled T2DM groups (MD=138.14; 95%CI=10. 65-286.94; p=0.046). A weak significant negative correlation was found between hemoglobin and hepcidin levels by the Spearman correlation test (r=-0.259; p=0.043). Conclusion:There was a significant difference between the mean hemoglobin and hepcidin levels in the controlled T2DM group compared to uncontrolled T2DM group patients. A weak statistically significant negative correlation was found between hepcidin levels and anemia in T2DM patients.