BACKGROUND: The mutation spectrums of hemoglobinopathy are different among populations that yield a different result of erythrocyte indices. Calculation of erythrocyte indices with some formula has been reported to differentiate between hemoglobinopathy and non-hemoglobinopathy, but its cut-off should be recalculated specific for each population to gain a better sensitivity and specificity. We aimed to evaluate red blood cell count (RBC), Mentzer index, red cell distribution width (RDW), RDW index (RDWI), Shine and Lal index (S&L) and Green and King index (G&K) to screen hemoglobinopathy in Indonesia.METHODS: A retrospective cross-sectional study was performed on 202 subjects. The diagnosis of hemoglobinopathy was determined based on the results of complete blood count (CBC) data, high-performance liquid chromatography (HPLC) and Hemoglobin H (HbH) inclusion body. The ferritin concentration was checked to determine the status of iron. The erythrocytes indices were analyzed and calculated to predict hemoglobinopathy. RESULTS: A total 202 subjects who met the criteria were involved in this study. Fifty percent showed pure hemoglobinopathy and 4% showed a combination of thalassemia and hemoglobinopathy. The hemoglobin concentration and RBC were significantly higher, and the mean corpuscular volume (MCV) and RDW were significantly lower in hemoglobinopathy compared to iron deficiency. The difference was not significant if the hemoglobinopathy was combined with iron deficiency. By this study's cut-off, the G&K and RDWI showed the highest accuracy, sensitivity, and specificity.CONCLUSION: The new cut-off of erythrocyte index and its calculation to screen hemoglobinopathy in Indonesia showed a higher sensitivity and specificity, especially for G&K and RDWI with cut-off 73 and 228, respectively. The presence of iron deficiency in hemoglobinopathy could decrease the sensitivity.KEYWORDS: hemoglobinopathy, RBC, Mentzer index, RDW, RDWI, S&L, G&K

AbstrakLatar belakang: Terdapat kaitan antara stroke dengan protein S100B dan glial fibrillary acidic protein (GFAP) yang terlepas saat iskemia. (OR = 3,9; p < 0,001) . Nilai median kadar GFAP didapatkan lebih tinggi bermakna pada subyek yang masuk dengan NIHSS berat (nilai median 0,374 ng/mL) daripada yang masuk dengan NIHSS ringan (nilai median 0,047 ng/mL) dan sedang (nilai median 0,043 ng/mL) (p < 0,05). Kesimpulan: Kadar protein S100B semakin tinggi bermakna seiring dengan semakin beratnya NIHSS, sedangkan kadar GFAP yang tinggi bermakna baru didapatkan pada kasus dengan NIHSS AbstractBackground: S100B protein and glial fibrillary acidic protein (GFAP) released during ischemia have been associated with stroke. This study aimed to know whether there was a correlation between the concentration of these markers with the severity of neurological deficit in ischemic stroke.

AbstrakTujuan Kadar plasminogen activator inhibitor-1 Hasil Kadar PAI-1 yang tinggi ditemukan lebih sering pada penderita stroke iskemik daripada subjek kontrol (21.1% vs. 7.9 % dengan OR 3.1;. Analisa terhadap semua subjek yang diteliti menunjukkan adanya hubungan negatif yang lemah namun bermakna antara kadar PAI-1 dengan usia (r = -0.4; P = 0.000). Kadar PAI-1 yang tinggi ditemukan lebih sering pada subjek berusia muda (40 -58 tahun) daripada subjek berusia lebih tua ( 60 -84 tahun) (20 vs. 9 .8 %) (P = 0.004). Kesimpulan Dari hasil penelitian pendahuluan ini diduga ada hubungan antara kadar PAI-1 dengan stroke iskemik pada usia muda. Penelitan lebih lanjut dengan jumlah subjek yang lebih besar diperlukan untuk memastikan keadaan ini. (Med J Indones 2010; 19:158-63) AbstractAim Recently, increased plasminogen activator inhibitor-1 (PAI-1) has been known a risk factor for ischemic heart disease. However, the association of increased PAI-1 level with ischemic stroke remains unclear. The aim of this study was to analyze the association of PAI-1 level with ischemic stroke.Methods By case control design we involved 38 ischemic stroke and 38 risky-matched control subjects who fulfilled the criteria. The PAI-1 level was determined by ELISA method using Asserachrom PAI-1 from Stago. ResultsHigh PAI-1 level was found more frequent in ischemic stroke subjects than in control subjects (21.1% vs. 7.9 % with OR 3.1; 95 % CI 0.757 -12.790). The analysis of all studied subjects showed that there was a weak negative correlation between PAI-1 level and age (r = -0.4; P = 0.000). High PAI-1 level was found more frequent in younger (40 -58 years old) than in the older subjects (60 -84 years old) (20% vs. 9.8 %) (p=0.004). ConclusionThe result of this preliminary study suggested an association between PAI-1 level and ischemic stroke in younger age. Further study with larger subjects is recommended to confirm this association. Stroke is the second most common cause of death in the world, with almost 5.1 million people died annually due to stroke. In an attempt for stroke prevention, stroke risk factors should be recognized and controlled.1 In the last decade several conditions associated with stroke Have revealed that plasminogen activator inhibitor-1 (PAI-1) was suspected to play a role in stroke incidence. 2Plasminogen activator inhibitor-1 is the main physiologic regulator in fibrinolytic system since it can inhibit the activity of plasminogen activator. Increased PAI-1 level results in decreased fibrinolytic activity and, therefore, increases the risk of thrombosis.2 It was reported that PAI-1 may influence the progression of atherosclerosis. Increased PAI-1 level causes atherosclerotic lesion susceptible to thrombotic complication. [3][4][5][6] Increased PAI-1 level has been found in some myocardial infarct cases. 7 The risk for myocardial infarction is 3.35 times higher in subjects with high level of PAI-1 compared to those with the normal level of PAI-1. 8 The properties of vasculature in the heart and brain are diff...

BACKGROUND: Patient with larger ischemic lesion will suffer more severe neurogical deficit. The utility of MRI for lesion size measurement is still limited, therefore additional approach was pursued through examination of markers released by damaged brain cell, GFAP and S100B protein. The aim of this study is to know whether both markers are associated with the neurological deficit of anterior circulation ischemic stroke. METHODS: This observational prospective study enrolled 74 patients with anterior circulation ischemic stroke diagnosis. GFAP and S100B protein were measured with ELISA using blood collected at 48 to 72 hours after onset. The neurological deficit was assessed with NIHSS ad discharged.RESULTS: There was a significant association between GFAP level and discharged NIHSS (p=0.008) with 100% sensitivity and 100% negative predictive value. S100B protein also showed a significant correlation with discharged NIHSS (r=0.488; p=0.000) and this correlation could be described with an equation (OR=1.009; 95% CI=1.0003-1.0188; p=0.044). S100B protein at 78.3215 ng/L would give true prediction as 73.9% (95% CI=62.7%-85.2%, p=0.001). CONCLUSIONS: GFAP and S100B protein that were measured at 48 to 72 hours after onset were significantly associated with NIHSS at discharge. KEYWORDS: GFAP, S100B protein, discharged NIHSS, ischemic stroke

BACKGROUND: C-Reactive protein (CRP) and matrix metalloproteinase (MMP)-9 are inflammatory mediators that are often associated with the evolution of stroke. In this study, we aimed to find out whether concentration of these biomarkers were associated with the severity of discharge National Institute of Health Stroke Scale (NIHSS) in ischemic stroke patient.METHODS: In prospective stody, we involved 143 ischemic stroke patient who were admitted to hospital not more than 72 hours after the onset and who met the criteria. The concentration of CRP was assessed by High Sensitivity CRP reagent from Siemens and the concentration of MMP-9 was measure with Quantikine Human MMP-9 (total) Immunoassay from R&D. The outcome of stroke was determined by NIHSS score at discharge.RESULTS: There was a significant correlation between the CRP level and the severity of NIHSS at discharge (r = 0.288, p = 0.000). Subjects with intermediate/high level of CRP had a higher probability to have a moderate or even severe NIHSS (OR = 1.7, p = 0.004). Subjects with high MMP level showed a higher probability to have a severe NIHSS. CONCLUSION: The measurement of CRP and MMP-9 at 48-72 hours after stroke onset were associated with the severity of ischemic stroke based on NIHSS score at discharge.  KEYWORDS: inflammation, CRP, MMP-9, discharged NIHSS