Obesity is a metabolic disease that is caused by a lack of physical activity and is associated with an increased risk of chronic inflammation. A total of 40 obese adolescent females with an average age of 21.93 ± 1.35 years and average body mass index (BMI) of 30.81 ± 3.54 kg/m² were enrolled in this study, randomized, and divided into four groups, i.e., control (CTL; n = 10), moderate intensity aerobic training (MAT; n = 10), moderate intensity resistance training (MRT; n = 10), and moderate intensity combined aerobic–resistance training (MCT; n = 10). The enzyme-linked immunosorbent assay (ELISA) kits method was used to analyze the adiponectin and leptin levels between pre-intervention and post-intervention. Statistical analysis was conducted using a paired sample t-test, while correlation analysis between variables used the Pearson product–moment correlation test. Research data showed that MAT, MRT, and MCT significantly increased adiponectin levels and decreased leptin levels compared to the CTL (p ≤ 0.05). The results of the correlation analysis of delta (∆) data showed that an increase in adiponectin levels was significantly negatively correlated with a decrease in body weight (BW) (r = −0.671, p ≤ 0.001), BMI (r = −0.665, p ≤ 0.001), and fat mass (FM) (r = −0.694, p ≤ 0.001) and positively correlated with an increase in skeletal muscle mass (SMM) (r = 0.693, p ≤ 0.001). Whereas, a decrease in leptin levels was significantly positively correlated with a decrease in BW (r = 0.744, p ≤ 0.001), BMI (r = 0.744, p ≤ 0.001), and FM (r = 0.718, p ≤ 0.001) and negatively correlated with an increase in SMM (r = −0.743, p ≤ 0.001). In summary, it can be concluded that our data show that adiponectin levels increased and leptin levels decreased after the intervention of aerobic, resistance, and combined aerobic–resistance training.

Hemolysis is the most common reason why coagulation test samples are rejected. However, the effects of hemolysis on plasma prothrombin time (PPT) and activated partial thromboplastin time (APTT) are rarely investigated and the results are controversial. This research aims to analyze the effects of hemolysis on PPT and APPT using the photo-optical method.Nonhemolyzed citrate blood samples (n = 30) with normal PPT and APTT underwent 2-step mechanical lysis and then hemoglobin level measurement was carried out at each step. The first lysis was mild to moderate resulting in a hemoglobin level of <0.8 g/dL. These samples were labeled as group 1. The second step showed more severe lysis, which resulted in a plasma hemoglobin level of ≥0.8 g/dL. These samples were labeled as group 2. Analysis was carried out on the PPT and APTT differences between the 2 groups and baseline, as well as between group 1 and group 2 using repeated-measures analysis of variance (ANOVA). The effects of hemolysis were analyzed using linear regression. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value in PPT and APTT.Significantly shorter APTT was measured for group 1 than baseline, (P = .000), group 2 than baseline (P = .000), and group 2 than group 1 (P = .003). With regard to PPT results, those for group 1 were significant shorter than baseline (P = .002), while those for group 2 were significantly longer than group 1 (P = .000). In the correlation assay, the level of hemolysis revealed a mildly significant correlation to APTT (R = 0.245; P = .02). Cut-off value for PPT was 1.55 g/dL (100% sensitivity and 87.9% specificity), while the value for APTT was 0.95 g/dL (75% sensitivity and 62.5% specificity).Not all hemolyzed samples should be rejected for PPT and APTT tests using photo-optical methods.

Background: The frequency of the beta-thalassemia (β-thalassemia) gene in Indonesia ranges from 3 to 10%. However, in the East Java province, there is still limited information on the prevalence of β-thalassemia mutations in clinically diagnosed beta-thalassemia patients of East Java. Therefore, this study aimed to characterize β-thalassemia mutations in selected patients in the East Java province of Indonesia.Methods: This is an analytical observational study. Diagnosis of β-thalassemia was based on clinical presentation, complete blood count (CBC), and hemoglobin (Hb) electrophoresis. Blood specimens taken from each patient in three ethylenediaminetetraacetic acid (EDTA) tubes were analyzed for CBC and Hb electrophoresis and processed for DNA extraction and subsequent polymerase chain reaction (PCR). Detection of mutations in Hemoglobin Subunit Beta (HBB) gene exons 1–3 of the β-thalassemia gene as the common mutation in Indonesia was done using PCR followed by Sanger sequencing.Results: In total, 33 (n = 33) participants were involved in this study with ages ranging from 5 to 17 years comprising 19 women and 14 men. Their ethnic origins were Javanese (n = 30) and Chinese (n = 3). CBC results showed that mean ± standard deviation (SD) for Hb, red blood cell (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW)-CV were 81.2 ± 7.0 g/L; 3.40 ± 0.39 × 10⁹/L; 71.05 ± 5.72 fL; 24.12 ± 2.45 pg; 33.91 ± 1.47 g/dl; 24.38 ± 6.02%, respectively. Hb electrophoresis revealed that 5 out of 33 participants had beta-thalassemia and 28 out of 33 participants had hemoglobinopathy (Hb) E/beta-thalassemia. Results of Sanger sequencing showed the following genotype variations in the samples: 12 (36.4%) with β^CD26/β^IVS−I−5; 6 (18.2%) with β^CD26/β^CD35; 3 (9.1%) with β^CD26/β^IVS−I−2; 2 (6.1%) with β^CD27/28/β^CD40; 2 (6.1%) with β^IVS−I−1/β^CAP+1; and β^CD26/β^IVS−I−1; β^IVS−I−5/β^CAP+1; β^IVS−I−5/β^CD35; β^CD26/β^CD37; β^CD26/β^CD15; β^CD26/β^CD40; and β^IVS−I−5/β^CD19 in 1 (3%) sample, respectively, and 1 (3%) had no abnormality detected in sequencing even though electrophoresis showed abnormality in the migration pattern. The β^CD26/β^IVS−I−5 mutation was found in samples that were noted to have Hb E/beta-thalassemia on Hb electrophoresis.Conclusion: The underlying genetic variations are heterogeneous in thalassemia patients in East Java, where 12 variants were found. The most common variant was β^CD26/β^IVS−I−5, which all accounted for Hb E/beta-thalassemia on Hb electrophoresis. Furthermore, 28 out of 33 participants had hemoglobinopathy (Hb) E/beta-thalassemia.

A complete blood count is a routine blood examination performed in laboratories. EDTA is the standard anticoagulant used in complete blood count examination. The use of ethylenamineintetraacetic acid (EDTA) may cause pseudo thrombocytopenia. The alternative to EDTA is sodium citrate and heparin anticoagulants. This study aimed to compare the results of complete blood count parameters using EDTA, sodium citrate, and heparin anticoagulants for the necessity of health service in the laboratory. The design of this study was a cross-sectional observational analytic done from October 2020 until November 2020. The participants of this study came from 62 adults who look healthy recruited in Medical Check-up Department. The sample was collected using K2- EDTA, 3.2% sodium citrate, and heparin tubes with volumes of 3ml, 3ml, and 4ml respectively. The sample was then examined using Sysmex XN 1000 hematology analyzer. There were no significant differences between the result of hemoglobin (HBG), red blood cells (RBC), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red cells distribution width (RDW), and white blood cells (WBC) parameters. The result of platetelet (PLT) was significantly different between the three tubes. The results of platelet examination with sodium citrate and heparin tubes were lower than those obtained with the EDTA tube. EDTA is still the best choice for a complete blood count, but sodium citrate and heparin anticoagulants can be used as alternatives for testing.

The aim of the research is to analyze the differences in the subset of T lymphocytes and NK cells at various degrees of disease severity in order to be used in stratification of patients’ management and to predict outcomes for optimal treatment. The study sample of 123 patients with confirmed COVID-19 was classified based on the degree of severity: 50 patients with mild severity, 34 patients with moderate severity and 39 patients with severe to critical severity who were subjected to complete blood count and T lymphocyte subsets (CD3, CD4, CD8) and NK cells with Flowcytometry. There were significant differences in the number of CD 3 cells (p=0.000), CD4 (p=0.000), CD8 (p=0.000), and NK cells (p=0.000) in the three groups. In the severe to critical group there was a decrease in lymphocytes accompanied by decrease of the number of CD3, CD4, CD8 and NK cells as well as an increase in WBC and neutrophils. Based on the outcome, there were significant differences in the number of CD 3 cells (p=0.000), CD4 (p=0.001), CD8 (p=0.000), and NK cells (p=0.001) between the Discharged and death groups. The decrease in the number of CD3, CD4, CD8 and NK cells indicates a relationship between changes in lymphocyte subsets and the pathogenesis of SARS-CoV-2, namely immune system disorders such as SARS infection. Increased of WBC with a decrease in CD3, CD4, CD8 and NK cell counts are associated with poor patient outcome. A significant decrease in the number of CD3, CD4, CD8 and NK cells in COVID-19 patients with severe to critical and moderate symptoms compared to mild groups and associated with poor patient clinical outcome.

Nastasya Nunki, M.S., Yetti Hernaningsih, M.D., Ph.D., Puspa Wardhani, M.D., Ph.D., Asih Herawati, M.D., Narazah Mohd Yusoff, MBBS., Ph.D., Emmanuel Jairaj Moses, Ph.D., and Bambang Pujo Semedi, M.D., Ph.D.. Ann Lab Med -0001;0:. https://doi.org/10.3343/alm.2023.0395